الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Pancreaticoduedenectomy is the operative of choice in
cases of resectable tumors of the periampullary region. Critical
step in pancreatic surgery is no longer the resection itself but
the reconstruction of the pancreaticoenteric anastomosis.
Different methods of pancreatic reconstruction have been
proposed aiming to limit the rate of leakage of pancreatic
anastomosis.
Surgeons have attempted to lower leak rates by devising
a number of anastomotic techniques such as end to end
pacreaticojejunostomy versus (vs) end to side pacreaticojejunostomy,
duct to mucosa anastomosis vs dunking
anastomosis, pacreaticojejunostomy versus pacreaticogastostomy
and the use of internal or external stent.
Many studies were constructed to compare the incidence
of leakage among different methods of pancreatic anastomosis.
The main aim was to define the ideal type of pancreatic
anastomosis so as to decrease morbidity and mortality.
Our study proved that there is no significant difference as
regard leakage after different types of pancreatic anastomosis.
However it was accidentally proved that there is a direct link
between pancreatic duct size, pancreatic texture and the
incidence of pancreatic fistula. In other words, soft pancreatic
texture and narrow duct have higher incidence of pancreatic
fistula.
Other factors affecting pancreatic leakage include
operative time, a surgeon’s skills and experience in performing
a PD, tumor location, and co-morbid illnesses.