Proximal gastrojejunal reconstruction after pancreaticoduodenal resection

M. Wayne, A. Cooperman, Rahul Narang, B. Abbadessa, J. Bratcher, W. Brown, J. Steele, F. Kasmin

Research output: Contribution to journalArticle

Abstract

Introduction. Reconstruction by proximal gastrojejunostomy, and distal biliary and pancreatic anastomoses is infrequently used after resection of the head of the pancreas because of fear of fistulas and cholangitis. Pancreaticoduodenectomy is being performed more frequently for cystic malignant and premalignant lesions. Because of this there is a need for endoscopic visualization and biopsy of the residual pancreatic duct, since multi-centricity is characteristic of some of these malignancies. Since endoscopic access of the bile duct and pancreatic duct is difficult and unsuccessful in 50-70% after B II or Roux Y reconstruction, we prospectively studied the merit and complications (early and late) of proximal gastrojejunal (PGJ) reconstruction after pancreaticoduodenal resection. Material and Methods. Thirty nine consecutive, non-radomized patients underwent pancreaticoduodenectomy and PGJ reconstruction over 14 mos. There were 21 males and 18 females. Results. 7 patients with IPMN have undergone repeat CT scanning for surveillance, with 3 requiring repeat EUS and ERCP. There were no technical difficulties accessing the pancreas or the pancreatic duct, supporting the PGJ reconstruction. Conclusion. Proximal gastrojejunal reconstruction following pancreaticoduodenal resection may be safely done with similar morbidity to traditional pancreaticojejunal reconstructions. PGJ reconstruction may be of greater value when direct visual access to the bile duct or pancreatic duct is necessary, and should be considered when doing resection for mucinous cysts or IPMN of the head of the pancreas.

Original languageEnglish (US)
Article number976268
JournalInternational Journal of Surgical Oncology
Volume2012
DOIs
StatePublished - 2012
Externally publishedYes

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Pancreatic Ducts
Pancreas
Pancreaticoduodenectomy
Bile Ducts
Cholangitis
Gastric Bypass
Endoscopic Retrograde Cholangiopancreatography
Fistula
Fear
Cysts
Morbidity
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Oncology
  • Surgery

Cite this

Wayne, M., Cooperman, A., Narang, R., Abbadessa, B., Bratcher, J., Brown, W., ... Kasmin, F. (2012). Proximal gastrojejunal reconstruction after pancreaticoduodenal resection. International Journal of Surgical Oncology, 2012, [976268]. https://doi.org/10.1155/2012/976268

Proximal gastrojejunal reconstruction after pancreaticoduodenal resection. / Wayne, M.; Cooperman, A.; Narang, Rahul; Abbadessa, B.; Bratcher, J.; Brown, W.; Steele, J.; Kasmin, F.

In: International Journal of Surgical Oncology, Vol. 2012, 976268, 2012.

Research output: Contribution to journalArticle

Wayne, M, Cooperman, A, Narang, R, Abbadessa, B, Bratcher, J, Brown, W, Steele, J & Kasmin, F 2012, 'Proximal gastrojejunal reconstruction after pancreaticoduodenal resection', International Journal of Surgical Oncology, vol. 2012, 976268. https://doi.org/10.1155/2012/976268
Wayne, M. ; Cooperman, A. ; Narang, Rahul ; Abbadessa, B. ; Bratcher, J. ; Brown, W. ; Steele, J. ; Kasmin, F. / Proximal gastrojejunal reconstruction after pancreaticoduodenal resection. In: International Journal of Surgical Oncology. 2012 ; Vol. 2012.
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