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Modified Cattell's pancreaticojejunostomy, buttressing for soft pancreases and an isolated biliopancreatic loop are safety measurements that improve outcome after pancreaticoduodenectomy: a pilot study

Modified Cattell's pancreaticojejunostomy, buttressing for soft pancreases and an isolated biliopancreatic loop are safety measurements that improve outcome after pancreaticoduodenectomy: a pilot study
Modified Cattell's pancreaticojejunostomy, buttressing for soft pancreases and an isolated biliopancreatic loop are safety measurements that improve outcome after pancreaticoduodenectomy: a pilot study
Background: Pancreatic anastomotic leak is one of the most serious complications following pancreaticoduodenectomy (PD). Various factors have been implicated as contributors to pancreatic anastomotic leaks, the incidence of which has been as high as 28% in some series.

Objectives: We describe technical modifications to Cattell's technique for pancreaticojejunostomy (PJ), with buttressing of ‘soft’ pancreases and use of an isolated biliopancreatic loop for reconstruction following a PD.

Methods: We report our early experience using this technique in 50 patients who underwent PD between May 2002 and June 2006.

Results: There was no mortality in our series. The postoperative morbidity rate was 32% (16/50), with major complications occurring in seven (14%) patients. Pancreatic leak occurred in one patient (2%) and bile leak in one patient (2%). Both patients were managed conservatively.

Conclusions: Reconstruction after PD using an isolated biliopancreatic loop and modifications to Cattell's technique for PJ, with buttressing of the soft pancreas, can be performed with a low risk of pancreatic anastomotic leakage.
pancreaticoduodenectomy, cattell, pancreaticojejunostomy, seromyotomy, buttressing
1365-182X
154-160
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Malik, Hassan Z.
07a4edfd-e6b7-4ef4-8120-6be46b04cb26
Hamilton-Burke, Werebena
4435f413-ce25-4a11-b4be-cc5a939eae00
Verbeke, Caroline
0b21a5d4-6ac9-4315-99e3-34f4a38dc626
Menon, Krishna V.
d07aeb0b-4e37-4f9a-b23c-55d5d35fa535
Abu Hilal, Mohammed
384e1c60-8519-4eed-8e92-91775aad4c47
Malik, Hassan Z.
07a4edfd-e6b7-4ef4-8120-6be46b04cb26
Hamilton-Burke, Werebena
4435f413-ce25-4a11-b4be-cc5a939eae00
Verbeke, Caroline
0b21a5d4-6ac9-4315-99e3-34f4a38dc626
Menon, Krishna V.
d07aeb0b-4e37-4f9a-b23c-55d5d35fa535

Abu Hilal, Mohammed, Malik, Hassan Z., Hamilton-Burke, Werebena, Verbeke, Caroline and Menon, Krishna V. (2009) Modified Cattell's pancreaticojejunostomy, buttressing for soft pancreases and an isolated biliopancreatic loop are safety measurements that improve outcome after pancreaticoduodenectomy: a pilot study. HPB, 11 (2), 154-160. (doi:10.1111/j.1477-2574.2009.00028.x). (PMID:10235519)

Record type: Article

Abstract

Background: Pancreatic anastomotic leak is one of the most serious complications following pancreaticoduodenectomy (PD). Various factors have been implicated as contributors to pancreatic anastomotic leaks, the incidence of which has been as high as 28% in some series.

Objectives: We describe technical modifications to Cattell's technique for pancreaticojejunostomy (PJ), with buttressing of ‘soft’ pancreases and use of an isolated biliopancreatic loop for reconstruction following a PD.

Methods: We report our early experience using this technique in 50 patients who underwent PD between May 2002 and June 2006.

Results: There was no mortality in our series. The postoperative morbidity rate was 32% (16/50), with major complications occurring in seven (14%) patients. Pancreatic leak occurred in one patient (2%) and bile leak in one patient (2%). Both patients were managed conservatively.

Conclusions: Reconstruction after PD using an isolated biliopancreatic loop and modifications to Cattell's technique for PJ, with buttressing of the soft pancreas, can be performed with a low risk of pancreatic anastomotic leakage.

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More information

Published date: March 2009
Keywords: pancreaticoduodenectomy, cattell, pancreaticojejunostomy, seromyotomy, buttressing

Identifiers

Local EPrints ID: 172183
URI: http://eprints.soton.ac.uk/id/eprint/172183
ISSN: 1365-182X
PURE UUID: 6ba20e2a-dba5-4b40-9d1f-c7cf6e8dcb24

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Date deposited: 25 Jan 2011 09:20
Last modified: 14 Mar 2024 02:27

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Contributors

Author: Mohammed Abu Hilal
Author: Hassan Z. Malik
Author: Werebena Hamilton-Burke
Author: Caroline Verbeke
Author: Krishna V. Menon

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