Pancreatic fistula after pancreaticoduodenectomy represents a critical trigger of potentially life-threatening complications and is also associated with markedly prolonged hospitalization. Many arguments have been proposed for the method to anastomosis the pancreatic stump with the gastrointestinal tract, such as invagination vs. duct-to-mucosa, Billroth I (Imanaga) vs. Billroth II (Whipple and...

A 73-year-old patient underwent pyloruspreserving pancreatic head resection due to a branch-duct type intraductal papillary mucinous neoplasm. At Day 7, repeat laparotomy was performed because of elevated amylase concentrations in the abdominal drains. During the procedure, signs of pancreatitis were observed but no pancreaticogastrostomy leak was seen. Drains provided continuous irrigation. At...

OBJECTIVE To review the current evidence on the efficacy of various interventions directed toward prevention of pancreatic fistula after pancreatoduodenectomy. DATA SOURCES A MEDLINE database search from January 1, 1990, to August 31, 2008, was performed to identify relevant articles using the keywords pancreatoduodenectomy, pancreaticojejunostomy, pancreaticogastrostomy, pancreatic anastomot...

To assess the influence of digestive juice on the pancreatic stump when pancreaticogastrostomy was performed after pancreatoduodenectomy, the pancreatic stump was anastomosed to the intact stomach (group I), the stomach after partial gastrectomy (group II), or the jejunum (group III) in rabbits, and the nature of the digestive juice at the anastomotic site as well as the histologic changes of t...

Background and Purpose: Surgery remains the mainstay therapy for pancreatic head (PH) and periampullary carcinoma (PC) and provides the only chance of cure. Improvements of surgical technique, increased surgical experience and advances in anesthesia, intensive care and parentral nutrition have substantially decreased surgical complications and increased the survival. The aim of this prospective...