The clinical results of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy in consecutive 55 cases

Objectives: Pancreatic anastomotic leakage remains a major troublesome complication after pancreaticoduodenectomy. Thus, various technical modifications regarding the pancreatic anastomosis after pancreaticoduodenectomy have been attempted to minimize anastomotic leakage. We have performed duct-to-mucosa pancreaticojejunostomy with resection of jejunal serosa (layer-to-layer pancreaticojejunostomy) and obtained extremely favorable results. Methods: During 1999 to 2006, 55 patients (27 women and 28 men) underwent duct-to-mucosa pancreaticojejunostomy with resection of jejunal serosa after pancreaticoduodenectomy. The mean age was 64.6 years (range, 33-84 years). Results: Median postoperative hospital stay was 32.8 days. Morbidity rate due to early postoperative complication was 9.1% (pneumothorax in 1, pulmonary embolism in 1, gastric ulcer in 1, and wound infection in 2), with no pancreatic anastomotic leakage. Conclusions: There was low complication rate and no pancreatic anastomotic leakage in consecutive 55 patients who underwent pancreaticoduodenectomy. We consider that duct-to-mucosa pancreaticojejunostomy with resection of jejunal serosa is extremely safe, reliable, and favorable for the anastomosis after pancreaticoduodenectomy.