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Pancreaticojejunostomy with closure of the pancreatic stump by endoscopic linear stapler in laparoscopic pancreaticoduodenectomy: A reliable technique and benefits for pancreatic resection
Author(s) -
Nakamura Yoshiharu,
Matsumoto Satoshi,
Matsushita Akira,
Yoshioka Masato,
Shimizu Tetsuya,
Yamahatsu Kazuya,
Uchida Eiji
Publication year - 2012
Publication title -
asian journal of endoscopic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.372
H-Index - 18
eISSN - 1758-5910
pISSN - 1758-5902
DOI - 10.1111/j.1758-5910.2012.00145.x
Subject(s) - medicine , pancreaticoduodenectomy , pancreatic fistula , surgery , pancreas , distal pancreatectomy , complication , laparoscopy , resection
We introduce a technique for pancreaticojejunostomy with closure of the pancreatic stump by endoscopic linear stapler as a reliable intervention with benefits for pancreatic resection in laparoscopic pancreaticoduodenectomy ( L ap‐ PD ). Materials and Surgical Technique Following laparoscopic resection, we perform pancreaticojejunostomy under direct visualization. We employ the same method as in open surgery and enter via a 4–5‐cm incision, the minimum size feasible for easy removal of resected material from the body, positioned directly above the stump of the distal pancreas. In J anuary 2011, we began using endoscopic linear stapler when cutting the pancreas during Lap‐ PD in order to reduce the leakage of pancreatic juice, which may contain tumor cells from the neoplastic lesion. Since then, we have used this procedure in 12 subjects undergoing L ap‐ PD and 5 subjects undergoing laparoscopic central pancreatectomy. We have observed postoperative complication in only one of the laparoscopic central pancreatectomy cases, involving grade B / C pancreatic fistula, and in none of the Lap‐ PD cases. Discussion Our pancreaticojejunostomy with closure of the pancreatic stump by endoscopic linear stapler is a feasible procedure in Lap‐ PD and has produced positive results over a short time frame.