SAFETY OF PANCREATICOGASTROSTOMY AFTER PANCREATICODUODENECTOMY

During the period from January 1993 to May 1995, we performed a new technique of pancreaticogas-trostomy with gastrotomy in the anterior gastric wall for pancreatic reconstruction in 38 consecutive patients undergone pancreaticoduodenectomy. Our new pancreaticogastrostomy is performed as follows: A longitudinal gastrotomy is made in the anterior gastric wall and transverse gastrotomy is made in the posterior gastric wall from the lumen. Pancreaticogastrostomy is completed with interupted sutures between 1.5cm of the below from the stump of the pancreas and the full thickness of the posterior gastric wall from the lumen. Next, between the gastric mucosa and circumferentially around the stump is completed with interrupted sutures. Finally, gastrotomy in the anterior gastric wall is closed. After completionof the pancreaticogastrostomy, hepatojejunostomy is performed to reconstruct the biliary tract. We perform the Billroth I type of the reconstruction of an end-to-side gastrojejunostomy. We performed this new technique in 38 patients leakage of this new pancreaticogastrostomy has occurred. We believe that this anastomosis is most easy and secure in the pancreatic-enteric anastomoses.