Pancreatico-jejunal anastomosis with invaginating Jenunal “J”-Loop. Preliminary report of a new technique

Introduction: The pancreatic anastomosis is the most demanding step after pancreaticoduodenectomy (PD) and the pancreatic fistula (PF) is the most dreaded complication. Many techniques have been investigated to assess the best way to deal with the pancreatic stump after PD and none of these has shown to be superior in terms of statistically significant reduction of PF rate. We report the preliminary experience of a new technique of pancreaticojejunostomy (PJ). Methods: Fifteen patients underwent PD for neoplasms with end-to-side PJ with dunking jejunal “J”loop, between July 2011 and March 2014. The data about their post-operative outcomes were analyzed. Results: There were no intra-operative neither post-operative deaths. One patient had a grade A PF (6.7%). Total post-operative complications occurred in 6 patients (40%), major post-operative complications occurred in 3 patients (20%). Conclusion: The new “sandwich” technique for dunking PJ after PD that we describe proved to be easy to perform and sure. It appears to be suitable for a dunking PJ when the diameter of the jejunum is too small than this of the pancreatic stump.