Occlusion of the Main Pancreatic Duct as a Method to Avoid a Pancreatojejunal Anastomosis: Metabolic Consequences

The poor prognosis seen after the Whipple procedure greatly depends on leaks from pancreatic-duodenal anastomosis. Objective: To evaluate ligation of the pancreatic duct without reconstruction of the gastrointestinal tract continuity to prevent pancreatic postoperative fistula occurrence and to reduce surgical time. Methods: An experimental study was carried out on New Zealand adult rabbits who underwent pancreatic duct ligation without pancreatic-duodenal anastomosis. Pancreatic enzyme was administered orally to one operated group; another group of animals was operated on and monitored without enzyme replacement. Results: The groups were compared, and variations in weight and metabolic profiles were assessed. No significant differences were found between both operated groups in terms of postoperative mortality or reoperations. Discussion/Conclusion: The morbidity associated with pancreatic duct ligation is low, the procedure is well tolerated, and endocrine insufficiency does not seem to be a problem in the animal model.