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Case Reports in Medicine
Volume 2012 (2012), Article ID 657071, 4 pages
http://dx.doi.org/10.1155/2012/657071
Case Report

Double Duct to Mucosa Pancreaticojejunostomy for Bifid Pancreatic Duct following Pylorus Preserving Pancreaticoduodenectomy: A Case Report

1First Department of General Surgery, General Hospital Papageorgiou, West Ring Road, Nea Efkarpia 56 403, Thessaloniki, Greece
2Department of Radiology, General Hospital Papageorgiou, West Ring Road, Nea Efkarpia 56 403, Thessaloniki, Greece
3Department of Gastroenterology, Euromedica Kyanous Stavros General Hospital, Vizyis-Vyzantos 1, 54 636 Thessaloniki, Greece

Received 22 August 2012; Accepted 12 November 2012

Academic Editor: Yasuhiko Sugawara

Copyright © 2012 K. Vasiliadis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bifid pancreatic duct represents a relatively rare anatomical variation of the pancreatic ductal system, in which the main pancreatic duct is bifurcated along its length. This paper describes the challenging surgical management of a 68-year-old male patient, with presumptive diagnosis of periampullary malignancy who underwent a successful double duct to mucosa pancreaticojejunostomy for bifid pancreatic duct. Following pylorus preserving pancreaticoduodenectomy, careful intraoperative inspection of the cut surface of the residual dorsal pancreas identified the main in addition to the secondary pancreatic duct orifice. Bifid duct anatomy was confirmed via intraoperative probing and direct visualization of the ductal orifices. A decision was made for the performance of an end-to-site double duct to mucosa pancreaticojejunostomy. Postoperative outcome was favorable without any complications. Although bifid pancreatic duct is relatively rare, pancreatic surgeons should be aware of this anatomical variation and be familiar with the surgical techniques for its successful management. Lack of knowledge and surgical expertise for dealing with this anatomical variant may lead to serious, life threatening postoperative complications following pancreatic resections.