Prevention of pancreaticojejunal anastomotic leakage after pancreaticoduodenectomy with separate internal drainage of bile and pancreatic fluid.

OBJECTIVE: To introduce a new reconstructional procedure to decrease the complications after pancreaticoduodenectomy. METHODS: Separate internal drainage of bile and pancreatic fluid in pancreaticoduodenectomy was performed in 256 patients. The digestive tract was reconstructed with Child method, with invaginated pancreaticojejunostomy using a long silastic tube to drain pancreatic fluid internally, an end-to-side choledochojejunostomy and an end-to-side duodenojejunostomy or gastrojejunostomy. Gastrostomy drainage was also performed. RESULTS: No complications of pancreatic leakage were found. CONCLUSION: The separate internal drainage of bile and pancreatic fluid plays an important role in preventing pancreaticojejunal anastomotic leakage.