IDDF2018-ABS-0212 Pancreaticojejunostomy with intraoperative pancreatic stenting in whipple’s procedure – a single institute experience

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Abstract

Background

Pancreaticojejunal anastomotic leak is one of the dreaded complications after whipple’s procedure. Many surgical modifications of pancreatico-jejunal anastomosis have been described in the literature, but none are absolutely perfect. We aim to review our recent experience of whipple’s procedure with a technique of pancreatico-jejunostomy with intraoperative intrapancreatic stent placement and the postoperative procedure related morbidities and mortality.

Methods

In this retrospective study, patients undergoing whipple’s procedure for periampullary carcinoma and reconstructed with standard two layered pancreaticojejunostomy with pancreatic stent placement were analyzad from December 2015 to March 2018 and compared with standard technique. Preoperative characteristics of the patients as well as a postoperative pancreatic leak, its morbidity and mortality were compared.

Results

During the study period, 33 patients underwent the procedure. Median preoperative bilirubin and serum protein were 4.1 mg/dl and 7.35 gm/dl. Preoperative Common bile duct stenting was done in 5 patients and 26 patients were jaundiced. Median pancreatic duct diameter was 3.2 mm. The median duration of surgery was 5 hours. There was one patient with postoperative pancreatic leak (3%) with was managed conservatively. The median postoperative hospital stay was 15 days. Five patients required ICU care postoperatively. There was no postoperative procedure-related mortality.

Conclusions

Pancreaticojejunostomy with intrapancreatic stent placement is a viable option with low rate of postoperative pancreatic leak, its morbidities and mortality in cases of whipple’s procedure.

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