In this video we employ our technique of a modified pylorus preserving Whipple procedure. In this technique the pancreaticojejunostomy (PJ) is placed next to the gastrojejunostomy (GJ) on the short limb of a Roux jejunal loop while the hepaticojejunostomy (HJ) was performed on the long limb of the Roux jejunal loop. The GJ is performed at a distance of at least 25cm from the PJ anastomosis. Another 15- 25 cm distally to the GJ, the jejunum was transected and a Roux-en-Y loop was fashioned with the closed end of the transected long loop being anastomosed as an end-to-side HJ. By this surgical technique, contact of bile with PJ is avoided, therefore preventing the deleterious effects on the permeability of the pancreatic ductal system.
Video Contributed to the Society for Surgery of the Alimentary Tract (SSAT) International Relations Committee "How I Do It" Video Series: Pancreatic Resection by:
V. Smyrniotis, Professor of surgery
N. Arkadopoulos, Associate professor of surgery
I. Tzanoglou, MD, Surgeon
Correspondence: Nikolaos Arkadopoulos, Associate professor, Rimini 1 street, Chaidari, Greece
Visit ssat.com to learn more about the Society for Surgery of the Alimentary Tract.
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