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04 Dec 2023 (Vol 46 , Iss 12 )

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30 Nov 2023 (Vol 46 , Iss 11 )

Journal ID : TMJ-08-08-2022-11364
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Title : A NOVELLY INTRODUCED APPLICATION ALL OVER THE PANCREATIC CUT END, EFFICIENTLY PROTECT AGAINST PANCREATIC LEAKAGE FOLLOWING LEFT PANCREATECTOMY (DEBAKEY TECHNIQUE)

Abstract :

Pancreatic fistula (PF) is a common pancreas-specific complication after pancreatic resection, with an incidence of around 30% after left pancreatectomy, despite being largely performed in specialized hospitals. The current study describes a new technique of application of a seromuscular jejunal coverage over the pancreatic stump following left pancreatectomy. This study comprised patients at Cairo University's National Cancer Institute and Dar AlFouad Hospital in Egypt who had lesions in the pancreatic neck or body that allowed for a left pancreatectomy with a negative margin. The pancreatic stump was managed using two methods: first, sutures were used to close the end, and then a jejunal loop was used to compress the thick pancreatic stump in this group of patients. The pancreatic left end, which resembles the residual right stump after pancreatico-dudenectom in thickness, is securely covered, closed, and compressed by the newly described compression method in this area. Our innovative approach was used in 17 cases of left pancreatectomy. In eight of the seventeen cases, soft pancreas was present. The median age of the participants ranged from 19 to 67 years old. Transient fistula or biochemical leakage occurred in one case (5.88%). Our preliminary experience suggests that this approach is practical, safe, and quick, and that it can significantly reduce the risk of postoperative pancreatic fistula after left pancreatectomy, especially when the residual pancreatic stump is thick.

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