A NOVEL SURGICAL APPROACH TO RECONSTRUCTION IN PANCREATICODUODENECTOMY USING AN ISOLATED PANCREATIC LOOP

Abstract

Background and Aim: To analyze the feasibility, safety, and postoperative outcomes of isolated pancreatic loop reconstruction in patients undergoing pancreaticoduodenectomy. Methods: A dual Roux-en-Y procedure was used for reconstructing patients after the procedure, utilizing an isolated jejunal limb for pancreaticojejunostomy and a different jejunal limb for hepaticojejunostomy and gastrojejunostomy. The length of hospital stay, surgical complications, and perioperative results were assessed and contrasted with those of patients undergoing traditional Whipple reconstruction. Results: The use of a separate pancreatic loop was associated with a significantly lower incidence of delayed gastric emptying and postoperative pancreatic fistula (pancreatic juice leak). Patients in the dual-loop reconstruction group demonstrated faster recovery of gastrointestinal function and a shorter overall hospital stay compared with those who underwent conventional reconstruction. The rates of anastomotic leakage and other major postoperative complications were comparable between the two groups. Conclusion: The use of a separate pancreatic loop in Whipple surgery is a promising reconstructive approach that may improve postoperative outcomes by reducing delayed gastric emptying and pancreatic juice leakage, facilitating faster gastrointestinal recovery, and shortening hospital stay, while maintaining comparable rates of anastomotic leakage and other major complications.