Transection of the pancreas and closing the pancreatic duct using linear stapler followed by dunking method pancreaticojejunostomy versus duct to the mucosa in Whipple operation

Background: The anastomosis between the pancreatic stump and the gastrointestinal tract remains the most effectiveand safe method of controlling the pancreatic stump as it preserves the exocrine functions of the gland. The results of theprevious literature seem contradictory.Patients and Methods: This study was performed on 40 patients. Patients were divided into two groups. Group A wasmanaged by a division of the pancreas with linear stapler then dunking pancreaticojejunostomy, while group B wasmanaged by a duct to mucosa pancreaticjejunostomy. The primary outcome was the incidence of pancreatic fistula.Results: Regarding the incidence of pancreatic fistula, group A showed a zero rate of pancreatic fistula while group B had30% pancreatic leak. The mortality rate reached 15% in group B.Conclusion: Invagination technique by dividing the pancreas using the linear stapler then invagination appears superiorto duct to mucosa technique as regards the incidence of pancreatic fistula.