Minimizing shear and compressive stress during pancreaticojejunostomy: rationale of a new technical modification.
biomechanical · Level V
Where this comes from
- Record sourced from PubMed, PMID 24369374.
- Also identified by DOI 10.1001/jamasurg.2013.2256.
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Abstract
The failure of the pancreaticojejunal anastomosis remains an important and potentially lethal postoperative complication after pancreaticoduodenectomy. During the pancreaticojejunostomy, creation of compressive and shear forces during suture placement and knot tying may cause deformation of and cutting through the fragile pancreatic parenchyma. We sought to understand the mechanics of needle-pancreas interaction and make adjustments to our pancreaticojejunostomy technique so that the creation of shear and compressive stress could be minimized. We provide a detailed description, a mathematical model, and analysis of the outcomes of our new technical modifications.
Medical subject headings
- Intraoperative Complications
- Pancreatic Neoplasms
- Pancreaticojejunostomy
- Postoperative Complications
- Suture Techniques