Pancreaticoduodenectomy for pancreatic cancer in Jehovah’s Witness using inferior pancreatoduodenal artery first approach IJRS Pancreaticoduodenectomy for pancreatic cancer in Jehovah’s Witness using inferior pancreatoduodenal artery first approach

Pancreaticoduodenectomy is an accepted procedure for management of pancreatic carcinomas. The procedure is associated with significant operative blood loss. Therefore, blood transfusion is an important supportive measure. Jehovah's Witnesses are widely known for their prohibition on the acceptance of blood transfusion. Despite their belief regarding transfusion, Jehovah's Witnesses do not have a higher mortality rate after traumatic injury or surgery. We represent the case of pancreaticoduodenectomy with vein resection in Jehovah’s Witness. During the November December 2011 period 2 female Jehovah’s Witness underwent pancreaticoduodenectomies for pancreatic cancer. Preoperative biliary stent was placed in second patient. Both patients had Whipple operation, using inferior pancreatoduodenal artery first approach. In the first case en-block resection of the affected superior mesenteric vein was done. Intraoperative blood loss was 100 ml in the first case and 200 ml in the second case. No postoperative complications occurred in the first case; postoperative period was complicated by pancreatic fistula grade B in the second case. No transfusion of blood and blood products was done in both cases. We did not use сell-saver in both cases. The contemporary surgical techniques make it possible to perform pancreaticoduodenectomy with minimal blood loss and low risk of surgical complications.