The pancreatico-enteric anastomosis has always been a great concern in pancreatoduodenectomy (PD), even been called “Achilles heel.” Pancreatic surgeons are interested in improving the anastomosis technique to prevent the pancreatic fistula rate. More than a hundred of anastomosis techniques were reported, all represent variations on two fundamental techniques: PJ (end-to-side duct to mucosa PJ and end-to-end invaginating PJ) and PG (end-to-side duct to mucosa PG and end-to-side invaginating PG). We reviewed the history of pancreatico-enteric anastomosis and divided it into three historical stages, as well as summarized the characteristics of each stage . The early stage is exploratory period (from 1898 to 1940), the characteristics of this stage are: (1) No consensus of the need for reconstruction of the pancreatic stump. (2) Only sporadic pancreatico-duodenal anastomosis or PJ is reported. (3) Animal experiment for PG, not clinically used. (4) Anatomical PD was clarified. The middle stage is maturity period (from 1941 to 1980), the characteristics of this stage are: (1) The two kinds of reconstruction sequences after PD were set up. (2) PJ became the mainstream anastomosis, several kinds of techniques were reported. (3) A few studies compared the clinical result for the different kinds of method the PJ anastomosis. (4) Several kinds of techniques for PG were introduced and performed for patients.
Some of the figures and contexts were reused with permission from our previous papers.
- 1.Liu Y, Wang X, Huang C. Historical review of pancreatico-enteric reconstruction following pancreatoduodenectomy. Chin J Dig Surg. 2018;17(7):671–6.Google Scholar