Pylorus-preserving Pancreatoduodenectomy (PPPD)by Imanaga Procedure for Periampullary Cancer, and Postoperative Endoscopic Findings of Pancreatic and Biliary Stomas (Video presentation) / Шинэ санаа Шинэ нээлт

ABSTRACT

After PPPD, we have consistently performed gastrointestinal reconstruction byImanaga procedure that entailed an end-to-end dudenojejunostomy, end-tosidepancreatojejunostomy (pancreatic duct to jejunal mucosa anastomosis) andcholedochojejunostomy, performed in that order.PPPD-Imanaga, which leaves no blind intestinal segment, simulates the normalanatomic arrangement and provides a physiological mixture of food and bilein the upper portion of the jejunum. The good mixing was evidenced by dualscintigraphy with few exceptions. As another advantages, insertion of endoscopyis easier postoperatively and as a result, we can check patency of pancreatic andbiliary anastomotic stomas. This is important to evaluate postoperative functionof remnant pancreas and liver, and early to detect local recurrence.Since 1986, we have experienced 272 cases of PPPD/PD-Imanaga (PPPD 233/ PD 39), which consists of patients with pancreatic head cancer 122, bile ductcancer 55, Vater cancer 36 and another 61.Overall 5-year-survival is 14.2% in pancreatic head cancer, and 25.3% in distalbile duct cancer.