Biomaterial Database

A novel triple secured technique for pancreatic reconstruction following pancreaticoduodenectomy for a soft pancreas. 2014

K Kakinoki, and K Okano, and M Oshima, and H Suto, and H Kashiwagi, and N Yamamoto, and S Akamoto, and M Fujiwara, and S Yachida, and T Takama, and M Hagiike, and H Usuki, and H Kamata, and T Masaki, and Y Suzuki

OBJECTIVE Soft pancreases are susceptible to developing pancreatic fistula following pancreaticoduodenectomy. To reduce the incidence of pancreatic fistula after pancreaticoduodenectomy in patients with a soft pancreas, we developed a triple secured technique. In this study, we describe the details of this technique and also report on the postoperative outcomes. METHODS The triple secured technique employed an ultrasonic dissector for pancreatic transection with skeletonizing and ligating of the small pancreatic branch ducts, duct-invagination or duct-to-mucosa anastomosis for main pancreatic duct management, and, finally, four large stitches between the pancreatic stump parenchyma and the jejunal seromuscular layer to prevent minor pancreatic leakage. A total of 28 consecutive patients with a soft pancreas who underwent pancreaticoduodenectomy using our technique were included in this study. RESULTS Postopetrative complications occurred in 16 patients. Grade B pancreatic fistula developed in 6 patients. However, no grade C pancreatic fistula occurred in this series. Neither any reoperation nor in-hospital mortality was observed in this series. CONCLUSIONS Our triple secured technique after pancreaticoduodenectomy was feasible and safe, with an acceptable rate of grade B pancreatic fistula and no grade C pancreatic fistula for patients with a soft pancreas.

UI	MeSH Term	Description	Entries
D007583	Jejunum	The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum.	Jejunums
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010182	Pancreatic Diseases	Pathological processes of the PANCREAS.	Disease, Pancreatic,Diseases, Pancreatic,Pancreatic Disease
D010183	Pancreatic Ducts	Ducts that collect PANCREATIC JUICE from the PANCREAS and supply it to the DUODENUM.	Duct of Santorini,Duct of Wirsung,Duodenal Papilla, Minor,Wirsung's Duct,Accessory Pancreatic Duct,Accessory Pancreatic Duct of Santorini,Main Pancreatic Duct,Santorini's Duct,Accessory Pancreatic Ducts,Duct, Accessory Pancreatic,Duct, Main Pancreatic,Duct, Pancreatic,Duct, Santorini's,Duct, Wirsung's,Ducts, Pancreatic,Main Pancreatic Ducts,Minor Duodenal Papilla,Minor Duodenal Papillas,Pancreatic Duct,Pancreatic Duct, Accessory,Pancreatic Duct, Main,Pancreatic Ducts, Accessory,Papilla, Minor Duodenal,Santorini Duct,Wirsung Duct,Wirsungs Duct
D010185	Pancreatic Fistula	Abnormal passage communicating with the PANCREAS.	Fistula, Pancreatic,Fistulas, Pancreatic,Pancreatic Fistulas
D011183	Postoperative Complications	Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery.	Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults