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Through-and-Through Transpancreatic Duct-to-Mucosa (Blumgart) Pancreaticojejunostomy

  • Rohit Chandwani
  • William R. Jarnagin
Chapter

Abstract

Postoperative pancreatic fistula (PF) is a common surgical complication following the Whipple procedure (pancreaticoduodenectomy). Several interventions have been advocated to diminish the rate of clinically significant fistulae, which can approach 30% in high-risk patients. The method of pancreatic anastomosis has been the subject of considerable study, and herein we describe the through-and-through transpancreatic duct-to-mucosa pancreaticojejunostomy, also known as the Blumgart anastomosis. Clinical evidence, including retrospective institutional series, comparison studies, and single-institution randomized trials all demonstrate a decreased incidence of PF, as well as improved secondary endpoints such as length of stay and overall surgical complications. Given these findings, we describe here the key considerations in this surgical technique and review the body of clinical evidence surrounding its utilization in the clinical setting.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Hepatopancreatobiliary Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkUSA

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