Pancreatojejunostomy. Evolution of Thinking and Modern Trends

Pancreatojejunostomy is a key stage in performing pancreatoduodenal resection, as it is one of the major factors for developing postoperative pancreatic fistulas. The paper demonstrates the evolution of thinking in the global surgical community regarding interventions on the pancreas in general and pancreatodigestive anastomosis in particular. The attitude of pancreatologists to pancreato-digestive anastomosis has undergone radical changes since the end of the 19th century to the present day. For a long time, surgeons were restricted to perform only partial resections of the head of the pancreas, based on the postulates of its inviolability. However, the rapid development of medical technologies and surgical art throughout the 20th century led to the formation of an algorithm for pancreatoduodenal resection in its modern version, as well as the creation of numerous techniques for forming an anastomosis between the remnant of the pancreas and the small intestine. The article describes and illustrates the main modern technologies for forming a pancreatic anastomosis. Based on the data of the world literature, modern technologies for pancreatic anastomosis, their features, advantages and disadvantages are assessed. Additional options to prevent pancreatic fistulas during the pancreatojejunostomy are highlighted. Modern techniques for predicting complications during pancreatoduodenal resection are also described.