Conservative resection is the procedure of choice for benign tumors and cysts of the pancreas. However, there are technical problems because of the vascular anatomy and the need for ductal reconstruction. Hence, most lesions arising from the body of pancreas are treated with a distal pancreatectomy. This entails loss of normal pancreatic tissue. There are a few reports of conservative middle segment pancreatectomy in such situations. 1-6 Reconstruction after middle segment pancreatectomy may be performed by closure of the cephalic end and anastomosis of the tail to a Roux loop of the jejunum. 3,5,6 Alternately, interposition of a jejunal loop to construct a sandwich pancreaticojejunostomy could be used, 7 but the normal pancreas is considered to have poor suture-holding properties, and there is a risk of disruption of the anastomosis. This article is a report of 3 patients for whom end-to-end anastomosis of the pancreas was carried out successfully. One patient underwent resection of the middle portion of the gland (median pancreatectomy) followed by reconstruction; this procedure is described in detail. The other 2 patients sustained complete transection of the neck of the pancreas because of blunt trauma to the upper abdomen. For each of these patients, end-to-end
Surgery – Elsevier
Published: Jun 1, 2002
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