Mahamana Technique of Pancreaticogastrostomy: A Safe and Reliable Technique for a Difficult Pancreatic Stump

TL;DR

This paper introduces a new surgical technique for pancreaticogastrostomy that shows promising results in reducing complications after complex pancreatic surgery.

Contribution

The paper presents a novel pancreaticogastrostomy technique using specific suturing methods for difficult pancreatic stumps.

Findings

The described technique used two transpancreatic sutures and a purse string suture for pancreaticogastrostomy.

Incorporating transpancreatic sutures into the third layer of gastrojejunostomy improved outcomes.

Short-term postoperative results were encouraging in eight patients.

Abstract

Pancreatoduodenectomy is a complex surgical procedure involving three anastomoses. Anastomosis of the pancreatic stump with the gastrointestinal tract is associated with most complications described in the postoperative period. So, there have been multiple attempts to discover safe and sound steps for this particular anastomosis. Pancreaticogastrostomy involves anastomosis between the remaining pancreas and stomach. Since it was first performed, its surgical steps have been modified multiple times, but there is no gold standard method to perform it. In this paper, we describe the surgical steps of pancreaticogastrostomy in difficult pancreatic stumps in eight patients using two transpancreatic sutures, one purse string suture, and the incorporation of transpancreatic sutures in the third layer of the gastrojejunostomy anastomosis. Postoperative outcomes of this series have provided encouraging short-term results.

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