Extra-pancreatic end-to-side hepaticojejunostomy: A practical modification of the duodenum-preserving pancreatic head resection (DPPHR) for chronic pancreatitis

Abstract

Background: Duodenum-preserving pancreatic head resection (DPPHR) is recognised for the surgical treatment of chronic pancreatitis. Approximately 15-20% of patients undergoing DPPHR require a synchronous biliary drainage procedure for stricture. Methods and results: This report describes a technical modification involving the placement of an extra-pancreatic end-to-side Roux hepaticojejunostomy utilising the same jejunal loop employed for pancreaticojejunal anastomosis. Discussion: Extra-pancreatic end-side hepaticojejunostomy is a simple technical modification of DPPHR. The biliary anastomosis is constructed according to the well-established principles of biliary reconstruction and represents a safe and valuable technical option.