Low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb after major hepatectomy with pancreatoduodenectomy

Surg Today. 2008;38(3):285-8. doi: 10.1007/s00595-007-3604-7. Epub 2008 Feb 29.

Abstract

We describe an effective technique for the low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb after major hepatectomy with pancreatoduodenectomy (PD). After hepatectomy and PD, reconstruction is performed by a modification of Child's method. A pancreaticojejunostomy is completed with interrupted sutures between the pancreatic duct and mucosa, without inserting a stent. During hepaticojejunostomy, a 10-F silicone drain with side channels (Blake Silicone Drain; Ethicon, Somerville, NJ, USA) is placed within the hepatic duct via the stump of the jejunal limb to drain bile and pancreatic juice. The drain is connected to a continuous suction device and low suction pressure is started. We found that the low-pressure continuous suction of bile and pancreatic juice from the hepatic duct and jejunal limb was very effective after major hepatectomy with PD.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Female
  • Gallbladder Neoplasms / pathology
  • Gallbladder Neoplasms / surgery*
  • Hepatectomy*
  • Hepatic Duct, Common / surgery
  • Humans
  • Pancreas / surgery
  • Pancreatic Juice
  • Pancreaticoduodenectomy*
  • Plastic Surgery Procedures
  • Postoperative Care
  • Postoperative Complications / prevention & control
  • Pressure
  • Stents
  • Suction / methods*