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Preliminary results of binding pancreaticojejunostomy.

Kim JM, Hong JB, Shin WY, Choe YM, Lee GY, Ahn SI - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: We analyzed the early results of binding pancreaticojejunostomy (BPJ), a technique reported by SY Peng.According to the post-operative course, 16 patients recovered well with no evidence of PF.The BPJ appears to be a relatively safe procedure based on this preliminary study, but further study is needed to validate its safety.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Inha University Hospital, Incheon, Korea.

ABSTRACT

Backgrounds/aims: The post-operative complications and clinical course of pancreaticoduodenectomy (PD) largely depend on the pancreaticojejunostomy (PJ). Several methods of PJ are in clinical use. We analyzed the early results of binding pancreaticojejunostomy (BPJ), a technique reported by SY Peng.

Methods: We retrospectively reviewed the clinical results of patients who received BPJ in Inha University Hospital from 2006 to 2011. 21 BPJs were performed with Peng's method. The definition of postoperative pancreatic fistula (PF) was a high amylase content (>3 times the upper normal serum value) of the drain fluid (of any measurable volume), at any time on or after the 3rd post-operative day. The pancreatic fistula was graded according to the International Study Group for Pancreatic Fistula (ISGPF) guidelines.

Results: Of the 21 patients who received BPJ, 11 were male. The median age was 61.2 years. PD surgery included 4 cases of Whipple's procedures and 17 cases of pylorus-preserving PD. According to the post-operative course, 16 patients recovered well with no evidence of PF. A total of 5 patients (23.8%), including 3 grade A PFs and 2 grade C PFs, suffered from a pancreatic fistula. 3 patients with grade A PF recovered with conservative management.

Conclusions: The BPJ appears to be a relatively safe procedure based on this preliminary study, but further study is needed to validate its safety.

No MeSH data available.


Related in: MedlinePlus

Surgical technique of binding pancreaticojejunostomy presented by Peng et al.6 (A) The pancreatic stump and the everted jejunum are brought together and sutured with silk. Care is taken to suture the mucosa only. (B) The remnant of the pancreas in the lumen of the jejunum is looped around and ligated together. A bundle of vessels is spared to maintain an intact blood supply to the jejunum cut end.
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Figure 1: Surgical technique of binding pancreaticojejunostomy presented by Peng et al.6 (A) The pancreatic stump and the everted jejunum are brought together and sutured with silk. Care is taken to suture the mucosa only. (B) The remnant of the pancreas in the lumen of the jejunum is looped around and ligated together. A bundle of vessels is spared to maintain an intact blood supply to the jejunum cut end.

Mentions: BPJs were done following Peng`s method.6,7,8,9 After everting 3 centimeters of the distal cut end of the jejunum, the exposed jejunal mucosa was destroyed with electric coagulation. The pancreatic stump and the everted jejunum were brought together and sutured with silk. The everted jejunum was then wrapped over the pancreatic stump and sutured to the pancreas with a few stitches for fixation. Lastly, at 1 cm from the cut end of the jejunum, a 2-0 Vicryl tie was looped around the entire circumference of the anastomosis (Fig. 1).


Preliminary results of binding pancreaticojejunostomy.

Kim JM, Hong JB, Shin WY, Choe YM, Lee GY, Ahn SI - Korean J Hepatobiliary Pancreat Surg (2014)

Surgical technique of binding pancreaticojejunostomy presented by Peng et al.6 (A) The pancreatic stump and the everted jejunum are brought together and sutured with silk. Care is taken to suture the mucosa only. (B) The remnant of the pancreas in the lumen of the jejunum is looped around and ligated together. A bundle of vessels is spared to maintain an intact blood supply to the jejunum cut end.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492331&req=5

Figure 1: Surgical technique of binding pancreaticojejunostomy presented by Peng et al.6 (A) The pancreatic stump and the everted jejunum are brought together and sutured with silk. Care is taken to suture the mucosa only. (B) The remnant of the pancreas in the lumen of the jejunum is looped around and ligated together. A bundle of vessels is spared to maintain an intact blood supply to the jejunum cut end.
Mentions: BPJs were done following Peng`s method.6,7,8,9 After everting 3 centimeters of the distal cut end of the jejunum, the exposed jejunal mucosa was destroyed with electric coagulation. The pancreatic stump and the everted jejunum were brought together and sutured with silk. The everted jejunum was then wrapped over the pancreatic stump and sutured to the pancreas with a few stitches for fixation. Lastly, at 1 cm from the cut end of the jejunum, a 2-0 Vicryl tie was looped around the entire circumference of the anastomosis (Fig. 1).

Bottom Line: We analyzed the early results of binding pancreaticojejunostomy (BPJ), a technique reported by SY Peng.According to the post-operative course, 16 patients recovered well with no evidence of PF.The BPJ appears to be a relatively safe procedure based on this preliminary study, but further study is needed to validate its safety.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Inha University Hospital, Incheon, Korea.

ABSTRACT

Backgrounds/aims: The post-operative complications and clinical course of pancreaticoduodenectomy (PD) largely depend on the pancreaticojejunostomy (PJ). Several methods of PJ are in clinical use. We analyzed the early results of binding pancreaticojejunostomy (BPJ), a technique reported by SY Peng.

Methods: We retrospectively reviewed the clinical results of patients who received BPJ in Inha University Hospital from 2006 to 2011. 21 BPJs were performed with Peng's method. The definition of postoperative pancreatic fistula (PF) was a high amylase content (>3 times the upper normal serum value) of the drain fluid (of any measurable volume), at any time on or after the 3rd post-operative day. The pancreatic fistula was graded according to the International Study Group for Pancreatic Fistula (ISGPF) guidelines.

Results: Of the 21 patients who received BPJ, 11 were male. The median age was 61.2 years. PD surgery included 4 cases of Whipple's procedures and 17 cases of pylorus-preserving PD. According to the post-operative course, 16 patients recovered well with no evidence of PF. A total of 5 patients (23.8%), including 3 grade A PFs and 2 grade C PFs, suffered from a pancreatic fistula. 3 patients with grade A PF recovered with conservative management.

Conclusions: The BPJ appears to be a relatively safe procedure based on this preliminary study, but further study is needed to validate its safety.

No MeSH data available.


Related in: MedlinePlus