Objectives: The adoption of laparoscopy for the Whipple procedure remains limited in part by its technical difficulty. We sought to develop a superior, simpler pancreaticojejunostomy technique.
Materials and Methods: We applied a running barbed suture (V-Loc™; Covidien, Mansfield, MA) to perform the pancreaticojejunostomy over a stent placed in the pancreatic duct and a small enterotomy in the jejunum. This technique was attempted in the last 19 of 37 patients presenting to two surgeons (M.A.M. and B.H.E.) for a laparoscopic Whipple procedure. Data were collected on operative time, pancreatic leak events, and related complications.
Results: We successfully applied the modified technique in all 19 patients. Pancreatic leak occurred in 5% of patients with the modified technique (Grade A=0; Grade B=1; Grade C=0) and 11% with the standard technique (Grade A=1; Grade B=1; Grade C=0). All leaks were managed with external drainage. There were no leak-related complications. Mean operative time was shorter for the modified technique (mean, 367 minutes; range, 260-576 minutes) than the standard technique (mean, 440 minutes; range, 300-665 minutes).
Conclusions: The use of a running barbed suture for laparoscopic pancreaticojejunostomy is a safe and efficient technique. Our operative times were decreased with this technique, and our outcomes were similar to other laparoscopic Whipple series.
|Original language||English (US)|
|Number of pages||5|
|Journal||Journal of Laparoendoscopic and Advanced Surgical Techniques|
|State||Published - Dec 1 2014|
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