Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 2/2010

01-02-2010 | How I Do It

Reconstruction Following the Pylorus Preserving Whipple Resection: PJ, HJ, and DJ

Authors: Eugene P. Kennedy, Jennifer Brumbaugh, Charles J. Yeo

Published in: Journal of Gastrointestinal Surgery | Issue 2/2010

Login to get access

Abstract

Introduction

Pancreaticoduodenectomy is one of the most challenging procedures performed by general surgeons.

Discussion

Many studies have been performed looking at the technical aspects of reconstruction after pancreaticoduodenal resection. Multiple randomized trials have failed to convincingly demonstrate the superiority of any single approach or technique. Here, we illustrate our approach to reconstruction, with an emphasis on technical aspects and details.

Conclusion

The fine points can help avoid technical errors that result in anastomotic failure.
Literature
1.
Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg 1935;102:763–779.CrossRefPubMed
2.
Lin JW, Cameron JL, Yeo CJ, Sohn TA, Lillemoe KD. Risk factors and outcomes in post-pancreaticoduodenectomy pancreaticocutaneous fistula. J Gastrointest Surg 2004;8:951–959.CrossRefPubMed
3.
Vin Y, Sima CS, Setrajdman GI et al. Management and outcomes of postpancreatectomy fistula, leak and abscess: results of 908 patient resected at a single institution between 2000 and 2005. J Am Coll Surg 2008;207:490–498.CrossRefPubMed
4.
Morgan DE, Texada JC, Canon CL et al. Multidetector computed tomography during combined therapy for pancreatic adenocarcinoma. Clin Gastroent Hepatol 2008;6:842–846.CrossRef
5.
Kennedy EP, Rosato EL, Sauter PK, Rosenberg LM, Doria C, Marino IR, Chojnacki KA, Berger AC, Yeo CJ. Initiation of a critical pathway for pancreaticoduodenectomy at an academic institution—the first step in multi-disciplinary team building. J Am Coll Surg 2007;204:917–924.CrossRefPubMed
6.
Sohn TA, Yeo CJ, Cameron JL et al. Resected adenocarcinoma of the pancreas—616 patients: results, outcomes and prognostic indicators. J Gastrointest Surg 2000;4:567–579.CrossRefPubMed
7.
Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo CJ, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M, International Study Group on Pancreatic Fistula Definition. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 2005;138:8–13.CrossRefPubMed
8.
Yeo CJ, Cameron JL, Maher MM, Sauter PK, Zahurak ML, Talamini MA, Lillemoe KD, Pitt HA. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Ann Surg 1995;222:580–592.PubMed
9.
Winter JM, Cameron JL, Campbell KA, Chang DC, Riall TS, Schulick RD, Choti MA, Coleman J, Hodgin MB, Sauter PK, Sonnenday CJ, Wolfgang CL, Marohn MR, Yeo CJ. Does pancreatic duct stenting decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 2006;10:1280–1290.CrossRefPubMed
10.
Yeo CJ, Cameron JL, Lillemoe KD, Sauter PK, Coleman J, Sohn TA, Campbell KA, Choti MA. Does prophylactic octreotide really decrease the rates of pancreatic fistula and other complications following pancreaticoduodenectomy? Results of a prospective randomized placebo-controlled trial. Ann Surg 2000;232:419–429.CrossRefPubMed
11.
Lillemoe KD, Cameron JL, Kim MP, Campbell KA, Sauter PK, Coleman JA, Yeo CJ. Does fibrin glue sealant decrease the rate of pancreatic fistula following pancreaticoduodenectomy? Results of a prospective randomized trial. J Gastrointest Surg 2004;8:766–774.CrossRefPubMed
12.
Berger AC, Howard TJ, Kennedy EP, Sauter PK, Bower-Cherry M, Dutkevitch S, Hyslop T, Schmidt CM, Rosato EL, Lavu H, Nakeeb A, Pitt HA, Lillemoe KD, Yeo CJ. Does the type of pancreaticojejunostomy after pancreaticoduodenectomy decrease the rate of pancreatic fistula? A randomized, prospective, dual-institution trial. J Am Coll Surg 2009;208:738–749.CrossRefPubMed
Metadata
Title
Reconstruction Following the Pylorus Preserving Whipple Resection: PJ, HJ, and DJ
Authors
Eugene P. Kennedy
Jennifer Brumbaugh
Charles J. Yeo
Publication date
01-02-2010
Publisher
Springer-Verlag
Published in
Journal of Gastrointestinal Surgery / Issue 2/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-1066-5

Other articles of this Issue 2/2010

Journal of Gastrointestinal Surgery 2/2010 Go to the issue

2009 SSAT Plenary Presentation

Duodenal Switch Provides Superior Resolution of Metabolic Comorbidities Independent of Weight Loss in the Super-obese (BMI ≥ 50 kg/m2) Compared with Gastric Bypass

Original Article

Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

Original Article

Survival Benefit of Non-curative Gastrectomy for Gastric Cancer Patients with Synchronous Distant Metastasis

Original Article

Surgical Management of Segmental and Sectoral Bile Duct Injury After Laparoscopic Cholecystectomy: a Challenging Situation

Multimedia Article

Supra-Pubic Single Incision Cholecystectomy

Original Article

Surgery for Obstructed Colorectal Malignancy in an Asian Population: Predictors of Morbidity and Comparison Between Left- and Right-Sided Cancers