Pancreatoduodenectomy offers the best chances for long-term survival to patients with pancreatic and periampullary malignancy. Due to an increased incidence of (pre-)malignant lesions and extended criteria for resectability, the number of patients undergoing pancreatic surgery is increasing. However, pancreatoduodenectomy is a technically challenging procedure, with a pancreatoenteric anastomosis as the standard procedure for managing the pancreatic remnant.
Failure of the pancreatic anastomosis, resulting in pancreatic fistula, is a dreaded complication after pancreatoduodenectomy. Anastomotic failure results in pancreatic fistula, which is associated with formation of intra-abdominal abcesses, postpancreatectomy hemorrhage, sepsis and even death. To reduce the incidence of pancreatic fistula, many types of pancreatoenteric anastomoses have been proposed. A complete overview of these technical different anastomoses is missing.
This website is the first to provide a complete overview of all pancreatic anastomosis techniques ever published in the literature. In total, 66 different techniques for pancreatic anastomosis are described, with clarifying illustrations. Based on three fundamental groups, i.e. end-to-end pancreatojejunostomy, end-to-side pancreatojejunostomy and end-to-side pancreatogastrostomy, all techniques are summarized into 19 subgroups.
This website can be used internationally, as an interactive platform for pancreatic surgeons to share their personal anastomosis technique with surgeons all over the world, and for uniformity in reporting anastomosis techniques in future research. It can also be used as a learning tool to give insight into the various possibilities of restoring pancreatoenteric continuity after pancreatoduodenectomy, for either the experienced or inexperienced surgeon.
Lois A. Daamen
for the Dutch Pancreatic Cancer Group