Roux-en-Y end-to-end and end-to-side double pancreaticojejunostomy: application of the reconstructive method of the Beger procedure to central panctreatectomy

Purposes: Central pancreatectomy is indicated for treatment of traumatic lesions and benign or low-grade tumors of the pancreatic neck and proximal body. After central pancreatectomy, the proximal pancreatic stump is usually closed, and pancreaticojejunostomy or pancreaticogastrostomy carried out with the distal pancreas. Adopting these reconstructive techniques in most series revealed a prevalence of postoperative fistula that was higher than after pancreaticoduodenectomy or left pancreatectomy. We present a case treated by novel application of the reconstructive method of the Beger procedure. Methods: Reconstruction by Roux-en-Y double pancreaticojejunostomy after central pancreatectomy was done in a 71-year-old female suffering from insulinoma of the proximal pancreatic body. Results: Postoperative complications were not observed. No alteration of pancreatic endocrine and exocrine function occurred at 22-month follow-up. Conclusions: Double pancreaticojejunostomy is a promising method for treating the proximal pancreatic stump after central pancreatectomy.