Reconstruction technique after pancreaticoduodenectomy

The many techniques proposed for the reconstruction of the digestive path after pancreaticoduodenectomy show the continuous research of the most anatomical and safest way to achieve the best results. Most of the technical variations concern the treatment of the pancreatic stump and are directed to prevent the pancreatic fistula that is the most frequent cause of postoperative mortality and morbidity. None of the pancreatico-digestive reconstruction ways is absolutely better than the others and we think neither the total obstruction of the Wirsung duct is the solution of the problem of the pancreatic fistula. The accuracy and technical precision, the availability to modify the technique in relationship to different anatomy and functional conditions of the pancreatic stump are essential to improve the results. To achieve this goal is decisive the experience and patients volume of the surgeon and of the institutional team.