DOUBLE PURSE STRING PANCREATICOGASTROSTOMY- A NOVEL TECHNIQUE FOR PANCREATIC STUMP RECONSTRUCTION FOLLOWING WHIPPLE'S PD dr.asurikrishna@gmail.com

 

DOUBLE PURSE STRING PANCREATICOGASTROSTOMY- A NOVEL TECHNIQUE FOR PANCREATIC STUMP RECONSTRUCTION FOLLOWING WHIPPLE'S PD

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India

Oral or Poster

Various modifications of the reconstruction following pancreaticoduodenectomy (PD) have been described. Pancreaticogastrostomy (PG) was first described clinically by Waugh and Clagett from the Mayo Clinic in 1946. Despite recent randomized trials and meta-analysis, the literature is still ambiguous as to which is a safer procedure. We hereby describe our experience of more than 100 pancreaticogastrostomies using a novel purse string technique.

A tertiary centre based prospective observational study was carried out, where we collected data of 102 patients who underwent Whipple’s procedure from March 2022 to January 2025, at the Department of Surgical Disciplines, AIIMS, New Delhi..

The mean operative time was 150- 180 min with an average blood loss of 400-500 ml. None of the patients had clinically significant POPF. Five patients had postoperative bleeding out of which 3 were early and 2 had delayed hemorrhage. The most common postoperative complication was delayed gastric emptying which was seen in 41 patients . Transient bile leak was seen in 7 patients . Wound infection was seen in 30 patients.

PG as a reconstructive technique is a safe option following PD with minimal incidence of clinically significant postoperative pancreatic fistula (POPF) as shown in our series of more than 100 patients.Our results indicate that the preferred reconstruction after classic Pancreaticoduodenectomy should be Pancreaticogastrostomy, but further validation with randomized control trials or multicenter studies with larger sample size are required.