Abstract text (incl. references and figure legends)
Background: We have three surgical options for pancreatic transection: distal pancreatectomy (DP), Letton-Wilson procedure (LW) and pancreatico-duodenectomy (PD). DP is generally preferred. As LW and PD are need pancreatic reconstruction that surgeons tend to avoid. However, in our case, the pancreas head and uncinate process were also severely damaged, while the body and tail were almost intact. DP was not reasonable because there was a big concern about diabetes or malnutrition.
Case report: 21-year male was injured by a motorcycle accident. As he was unstable upon arrival, after volume resuscitation he went to trauma pan scan and it showed severely injured pancreas and pneumoperitoneum. He had borough to operating room immediately. When the peritoneum was opened duodenal bulb and pancreas neck were completely transected. The sump of the proximal pancreas was sutured and distal was connected to the stomach with panceatico-gastrostomy (PG). Bowel reconstruction was made by Roux-Y. Post operative course was good, he could discharge without major complications.
Discussion: Modified LW using PG might be a good option for pancreatic transection. Here in, we introduce our easy way of PG in which distal pancreas is invaginated into the stomach and the fixation is made by only one stich.
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