Pancreaticoduodenectomy
Pancreaticoduodenectomy - Related Videos
10:09
Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy
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2026
Here, we present the stent-bridging pancreaticogastrostomy (PG) technique, which uses a stent to bridge the remnant pancreas to the stomach during open pancreaticoduodenectomy. The stent-bridging PG aims to simplify the anastomosis, achieve complete diversion of pancreatic juice, and minimize manipulation of the pancreatic remnant.
14:45
Technical Detail for Robot Assisted Pancreaticoduodenectomy
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Cited by 8 •
2019
The following manuscript details a stepwise approach to the robot-assisted pancreaticoduodenectomy performed at the University of Pittsburgh Medical Center.
00:13
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
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Cited by 2 •
2019
The technique of modified single-loop reconstruction following pancreaticoduodenectomy separates pancreatic secretion from bile, thus reducing the severity of POPF without prolonging the duration of surgery.
09:32
Management of the Uncinate Process in No-Touch Laparoscopic Pancreaticoduodenectomy
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Cited by 2 •
2023
Complete resection of the uncinate process and mesopancreas is one of the most important and difficult processes in laparoscopic pancreatoduodenectomy (LPD). This article presents a method for managing the uncinate process in no-touch LPD using the median-anterior and left-posterior approaches to the superior mesenteric artery (SMA).
04:31
Reverse Needle Continuous Suture of the Pancreatic Duct to Jejunal Mucosal Pancreaticointestinal Anastomosis in Laparoscopic Pancreaticoduodenectomy
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2025
To circumvent the difficulty in completing the anastomosis of the pancreatic duct and jejunal mucosa under laparoscopy for patients with a small pancreatic duct and soft and fragile pancreatic tissue, we introduce a reverse needle continuous suture technique for laparoscopic pancreaticojejunostomy of the pancreatic duct and jejunal mucosa.
FAQs
The operation addresses diseases centered in an anatomically connected region, so treatment may require removal of the pancreatic head together with the duodenum, gallbladder, and part of the bile duct. This wider resection reflects the locations involved in pancreatic, bile duct, and periampullary disease. The exact extent depends on the selected disease and the patient’s suitability for surgery.
After the diseased structures are removed, surgeons reconnect the remaining pancreas, bile duct, and stomach or intestine to the small bowel. These connections re-establish the pathways needed for gastrointestinal continuity. Reconstruction is therefore an essential second phase of the operation, not simply a closure step, and it influences the need for careful postoperative monitoring.
Candidates are selected according to the disease being treated and whether it is considered resectable. The procedure is used most often for resectable pancreatic or periampullary cancers, although selected bile duct and duodenal diseases may also be treated. Careful patient selection is important because the operation is complex and carries substantial postoperative risks.
Postoperative management focuses especially on pancreatic fistula, delayed gastric emptying, and infection. These complications represent different challenges after the resection and reconstruction, so patients require close observation and coordinated care. Recognizing the possibility of these problems is central to safely managing recovery and to evaluating the overall result of the operation.
The procedure has two broad phases: resection of the pancreatic head and nearby structures, followed by reconstruction of gastrointestinal continuity. The removed structures typically include the duodenum, gallbladder, and part of the bile duct. Reconstruction then connects the remaining pancreas, bile duct, and stomach or intestine with the small bowel.
For appropriately selected patients with resectable pancreatic or periampullary cancers, the operation can provide the possibility of long-term disease control. That potential benefit must be weighed against the complexity of the surgery and risks such as pancreatic fistula, delayed gastric emptying, and infection. Its role is therefore determined through careful clinical selection rather than routine use for every case.