Peng' s Pancreaticojejunal Anastomosis (Binding Pancreaticoje-junostomy) for the Pancreatoduodenectomy―A New Procedure Ensuring no Leakage

摘要

Objective To evaluate the safety and feasibility of a new operative procedure called binding pancreaticojejunostomy (BPJ) for the prevention of pancreatic leakage after pancreatoduodenectomy (PD) . Methods Binding pancreaticojejunostomy was performed in 100 patients from 1996 to 2000. During the operation, the cut end of the jejunum (3 cm) was everted, the everted mucosa of the jejunum was destroyed with carbolic acid. Meanwhile 3 cm long remnant of pancreas was isolated and sutured to 3 cm away form the jejunum cut end, care being taken not to penetrate the sero - muscular layer. Then, the everted jejunum was restituted to its normal position and the remnant of the pancreas was naturally pushed into the jejunal lumen for 3 cm. Finally, the surface of pancreatic remnant was closely in contact with destroyed jejunal mucosa surface, and a piece of absorbable thread was used to bind circumferentially this jejunum and the pancreatic remnant together, so no gap existed between the jejunal mucosa and pancreatic remnant. Results No pancreatic leakage occurred in the 100 patients with BPJ. Conclusion Binding pancreaticojejunostomy procedure can effectively prevent the occurrance of anastomatic leakage and can be applied broadly.