2017
DOI: 10.1590/0102-6720201700040008
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Abstract: Background : Pancreatic fistula is a major cause of morbidity and mortality after pancreatoduodenectomy. To prevent this complication, many technical procedures have been described. Aim: To present a novel technique based on slight modifications of the original Heidelberg technique, as new pancreatojejunostomy technique for reconstruction of pancreatic stump after pancreatoduodenectomy and present initial results. Method: The technique was used for patients with soft or hard pancreas and with duct size sma… Show more

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Cited by 11 publications
(13 citation statements)
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“…Soft pancreas with narrow ducts is better dunked into the stomach due to the technical ease. However, at expert hands with the aid of intraoperative loupe, duct-to-mucosa pancreatojejunostomy (modified Heidelberg technique) is an alternative with excellent outcome as was performed in the present case [ 8 ]. The nondilated bile duct (for hepaticojejunostomy) is better dealt with by wide spatulation or by using a Miller's cuff at the level of cystic duct insertion for narrowing free anastomosis to the jejunum.…”
Section: Discussionmentioning
confidence: 99%
“…Soft pancreas with narrow ducts is better dunked into the stomach due to the technical ease. However, at expert hands with the aid of intraoperative loupe, duct-to-mucosa pancreatojejunostomy (modified Heidelberg technique) is an alternative with excellent outcome as was performed in the present case [ 8 ]. The nondilated bile duct (for hepaticojejunostomy) is better dealt with by wide spatulation or by using a Miller's cuff at the level of cystic duct insertion for narrowing free anastomosis to the jejunum.…”
Section: Discussionmentioning
confidence: 99%
“…Torres et al in 2017 modified the original Heidelberg technique of pancreaticojejunostomy described by the Heidelberg group and later by Shrikhande et al and published their data of 17 patients. [2][3][4] We have been using a similar technique although with minor technical differences since 2008 in consecutive 208 patients.…”
Section: Discussionmentioning
confidence: 99%
“…Pancreatic fistulas have always been a dreaded complication after PA with current literature showing incidence somewhere between 3% and 45% probably because multiple techniques of pancreatic reconstruction have been described, and few authors have candidly reported their anastomotic dehiscence rates. [2] The consideration of multiple techniques of anastomosis, however, only points to the supposition that no one technique is irrevocably better than the other. Nevertheless, the detailed duct-to-mucosa anastomosis pioneered by the Heidelberg group in 2002 and later described by Shrikhande et al in 2007 continued to be one of the most commonly used techniques against which many other techniques were compared during the past decade.…”
Section: Introductionmentioning
confidence: 99%
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“…4c, d). Additionally, the intestine is fixed with two hemostatic stitches, previously placed in the pancreas (before the removal of the pancreatic head) [35].…”
Section: The Cattel-warren Techniquementioning
confidence: 99%