A modification of isolated Roux loop reconstruction after pancreaticoduodenectomy

Background: Different techniques of reconstruction following pancreaticoduo denectomy have been described. A new modification using an isolated Roux-en -Y loop is reported. Methods: The isolated loop is taken up to bile duct rather than pancreas as previously described. Results: Seventeen patients have undergone this procedure. Two pancreatic f istulae developed, both following postoperative abscess formation. There wa s no operative mortality. Conclusion: This reconstruction provides separation of biliary and pancreat ic fluid but adds two further benefits: the wide jejunal lumen allows for a n easier pancreaticojejunal anastomosis, particularly when operating on a s oft pancreas, and separation of gastric and biliary anastomoses prevents th e efflux of bile into stomach.