Transection of the pancreas and closing the pancreatic duct using linear stapler followed by dunking method pancreaticojejunostomy versus duct to the mucosa in Whipple operation

Document Type : Original Article

Authors

1 Department of General and Hepato-biliary Surgery, Faculty of Medicine, Minia University, Minia, Egypt

2 Department of General Surgery, Faculty of Medicine, Minia University, Minia, Egypt

3 Department of General Surgery, Faculty of Medicine, Minia University, Minia, Egypt.

Abstract

Background: The anastomosis between the pancreatic stump and the gastrointestinal tract remains the most effective
and safe method of controlling the pancreatic stump as it preserves the exocrine functions of the gland. The results of the
previous literature seem contradictory.
Patients and Methods: This study was performed on 40 patients. Patients were divided into two groups. Group A was
managed by a division of the pancreas with linear stapler then dunking pancreaticojejunostomy, while group B was
managed by a duct to mucosa pancreaticjejunostomy. The primary outcome was the incidence of pancreatic fistula.
Results: Regarding the incidence of pancreatic fistula, group A showed a zero rate of pancreatic fistula while group B had
30% pancreatic leak. The mortality rate reached 15% in group B.
Conclusion: Invagination technique by dividing the pancreas using the linear stapler then invagination appears superior
to duct to mucosa technique as regards the incidence of pancreatic fistula.

Keywords

The Egyptian Journal of Surgery
Volume 43, Issue 4
October 2024
Pages 1191-1201

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