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Surgical Treatment of the Pancreatic Stump: Technical Notes

  • Gianpaolo Balzano
  • Enrico Ortolano
  • Marco Braga
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

The aim of this chapter is to give an overview of different ways of treating the pancreatic stump after pancreaticoduodenectomy, describing and illustrating the surgical techniques, but neither addressing results nor comparing these reconstructive techniques, because that will be the subject of the next chapter. Here we describe the techniques of pancreaticojejunostomy and pancreaticogastrostomy (and their main variations), and the technique of occlusion of the main pancreatic duct (with no anastomosis). First, we will briefly treat two further important aspects: the choice of sewing materials and the preparation of the pancreatic stump. And a final recommendation: whatever technique you choose, pancreatic anastomosis will require a long, plodding procedure. Pancreatic surgery is not suited to the hasty surgeon.

Keywords

Pancreatic Duct Pancreatic Fistula Pancreatic Juice Main Pancreatic Duct Technical Note 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Muftuoglu MA, Ozkan E, Saglam A (2004) Effect of human pancreatic juice and bile on the tensile strength of suture materials. Am J Surg 188:200–203CrossRefPubMedGoogle Scholar
  2. 2.
    Z’graggen K, Uhl W, Friess H, Büchler MW (2002) How to do a safe pancreatic anastomosis. J Hepatobiliary Pancreat Surg 9:733–737CrossRefPubMedGoogle Scholar
  3. 3.
    Winter JM, Cameron JL, Campbell KA et al (2006) Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 10:1280–1290CrossRefPubMedGoogle Scholar
  4. 4.
    Warshaw AL, Thayer SP (2004) Pancreaticoduodenectomy. J Gastrointest Surg 8:733–741CrossRefPubMedGoogle Scholar
  5. 5.
    Bassi C, Butturini G, Salvia R et al (2006) Open pancreaticogastrostomy after pancreaticoduodenectomy: a pilot study. J Gastrointest Surg 10:1072–1080CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • Gianpaolo Balzano
    • 1
  • Enrico Ortolano
    • 1
  • Marco Braga
    • 1
  1. 1.Pancreas Unit, Department of SurgerySan Raffaele Scientific InstituteMilanItaly

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