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Pancreaticogastrostomy: How I Do It

  • R. Mahendran
  • H. S. Shukla
Chapter

Abstract

Pancreaticogastrostomy (PG) was first described by Waugh and Clagett from Mayo Clinic in 1946 [1]. Flaunter et al. popularized the technique and published their series in 1985 [2, 3]. Numerous theoretical and technical advantages are attributed to PG to explain the apparent safety of this procedure [4] including (1) the inactivation of pancreatic enzymes due to the low pH of the gastric lumen and lack of enterokinase in the gastric mucosa; (2) the alkaline pancreatic secretions that may help protect the pancreaticogastric anastomosis against marginal ulceration; (3) the anatomical proximity of the posterior gastric wall to the pancreatic remnant that allows for a very secure anastomosis without tension; (4) the thick gastric wall with its excellent blood supply that holds sutures very well; and (5) postoperative gastric decompression that is easily performed and provides constant removal of pancreatic and gastric secretions, thereby allowing less tension on the pancreaticogastric anastomosis.

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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • R. Mahendran
    • 1
  • H. S. Shukla
    • 1
  1. 1.Department of Surgical OncologyInstitute of Medical Sciences, Banaras Hindu UniversityVaranasiIndia

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