Leszek S. Kołodziejski, Zbigniew Darasz, Wojciech M. Wysocki
CaseRepClinPractRev 2005; 6:95-98
Background: A manual anastomosis of the extrahepatic biliary ducts with the jejunum during Whipple operation often connects with significant technical difficulties and prolongs anyhow long-lasting procedure. The introduction of the staplers into this particular surgical procedure could shorten and simplify the whole operation.Case Report: In three patients the anastomosis between the dilated common bile duct and jejunum or the fundus of the gallbladder and jejunum was performed with circular stapler. Another circular stapler was inserted through the stump of the stomach and the posterior wall of the stomach was anastomosed side-to-side with the jejunum. The stomach was closed with the linear stapler. This type of the reconstruction eliminates the necessity to make additional openings in the gastrointestinal tract wall. The staplers were introduced into jejunum and into stomach through their stumps produced by pancreatoduodenectomy. No complications attributed to the malfunction of the biloenteric anastomosis were observed in the follow-up. Two patients died from the neoplastic disease after 7 and 22 months. Third patient is alive with no evidence of disease. Conclusions: There is an opportunity to reconstruct the alimentary tract after resection of the pancreas head by anastomosing the biliary ducts (common bile duct and gallbladder) and jejunum with circular stapler. This method may simplify and shorten the whole procedure.
Keywords: Pancreatectomy/methods [MESH], Biliary Tract [MESH], Surgical Staplers [MESH], Anastomosis, Surgical [MESH]