Introduction : Pancreatoduodenectomy is the procedure of choice for treating periampullary and pancreatic head malignancy. Mortality is less than 5%. Unfortunately, the morbidity still hovers around 40 %. The Achiles heal of pancreatoduodenectomy is the pancreatoenteric anastamosis, the failure of which leads to significant morbidity. Literature is flooded with a plethora of techniques of reconstruction, and the results are variable. In the present study, we have analyzed a technique in which a single layer full thickness duct to mucosa pancreatojejunostomy was used.

Methods : The prospective observational pilot study was performed for a period of 21 months. During the study period, those patients who underwent a pancreaticoduodenectomy (for various conditions) and intra-operatively in whom the duct could be identified were included for the study. In those patients in whom the pancreatic duct could not be identified intraoperatively were excluded.

Results : A total of 25 (Male: Female, 1.25:1) patients were included in the study. 56% of them had an ampullary carcinoma, 36% had pancreatic head cancer and 8% patients had duodenal cancer. 20% patients developed a pancreatoenteric leak, out of which 80% patients had a grade A leak and 20% patient had a grade B leak, with no grade C leak.

Conclusions : This observational pilot study concludes that single layer full thickness interrupted duct to the mucosa, pancreatic-jejunostomy is efficient and is comparable to the other methods of reconstruction described in the literature pertaining to pancreatic specific complications.This technique is least traumatic to the pancreas and has an equal efficacy to the other conventional techniques.