الفهرس 
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Abstract
The present prospective study included forty patients with presumably operable lesions of the pancreatic head, the distal CBD on Multidetector Computed Tomography (MDCT) assessed for pancreaticoduodenectomy (PD) at the Hepato-biliary-pancreatic surgical unit of the Alexandria Main University Hospital, Alexandria, Egypt from August 2018 till April 2021.
The aim of the present study was to evaluate the use and the outcome of a selective policy for choosing the type of pancreatico-eneteric reconstruction following PD based on intra-operative assessment of pancreatic duct diameter and the extent of mobilization of the pancreatic remnant from the retroperitoneum (the distance from the transected margin).
Following preoperative evaluation and preparation of 70 patients for surgery, 23 patients were excluded (20 patients on CT basis and 3 patients due to poor general condition). 47 patients were admitted for PD, 40 patients completed their PD operation and were analyzed for different surgical outcomes while 7 patients were excluded due to intraoperative findings of unresectability/advanced disease.
PD was performed in the present study in 40 patients with the intraoperative choice of pancreaticoenteric reconstruction was according to the size of the pancreatic duct measured introperative and degree of intraoperative mobilization of the pancreatic remnant. Duct to mucosa anastomosis using the Kakita technique was performed in 29 patients while invagination type of reconstruction was performed in 11 patients (9 patients with invagination into the stomach while 2 patients with invagination into the jejunum). The study then evaluated the postoperative outcome of this selective policy.