Sezgin TOPUZ, Huseyin Kerem TOLAN, Bahtiyar MUHAMMEDOGLU, Suleyman KOKDAS

Whipple’s procedure and retrocolic gastroenteric anastomosis

Aim: Pancreatoduodenectomy (PD) is the only treatment option in patients with periampullary region tumors. Gastroenterostomy (GE) is carried out with or without Braun’s anastomosis according to preference.Material and Methods: Prospectively recorded files of 17 patients who underwent Whipple operation between September 2015 and March 2017 were retrospectively investigated for morbidity, mortality, and the way of GE anastomosis.Results: The youngest patient was 44 and the ldest was 75 years old with a mean age of 63.4. Six were male and 11 were female. Five cases (26%) were ductal adenocarcinoma, 11 (68%) were ampullary adenocarcinoma, and one (6%) was ampullary NET. Classical Whipple procedure was performed in all patients. Retrocolic GE was applied in all cases with Braun’s anastomosis in 6 and without in 11 patients. There were only two cases of panreatic fistula (grade B) (11.7%).Conclusion: Retrocolic gastroenterostomy under the omentum can provide more protected anatomical position providing advantage for lower and upper abdominal quadrant drainage in case of possible pancreaticojejunal leakages during pancreatoduodenectomy.

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