A New Surgical Technique of Transduodenal Pancreatic Juice Drainage Prevents Pancreatic Fistula following Distal Pancreatectomy

Abstract

Although, a variety of techniques have been described to reduce the risk of postoperative pancreatic fistula, there is no consensus on appropriate technique for closure of the pancreatic remnant after distal pancreatectomy. We developed a new surgical technique, transduodenal pancreatic juice drainage, for preventing postoperative pancreatic fistula. The procedure involves a transduodenal approach. A pancreatic stent was inserted into the main pancreatic duct from the papilla of Vater to its the distal side, and continuous suction drainage was performed. The pancreatic parenchyma was divided using a knife, and the main pancreatic duct was ligated. The cut surface of the remaining pancreas was closed by hand suturing. This procedure was performed on 10 patients, and none of them developed clinical postoperative pancreatic fistula. We consider our transduodenal pancreatic juice drainage technique to be an effective procedure for preventing postoperative pancreatic fistula in patients who have undergone distal pancreatectomy.