Complications - Pylorus-preserving pancreaticoduodenectomy (pp Whipple) with T-drain (PPPD)

1.1 Organ injury

• Stomach: Deserosation possible, but quite rare > oversew
• Bowel: Deserosation possible, but  rare > oversew
• Liver: Bleeding or bile leakage rare > electrocauterize, suture the liver

1.2 Vascular injury

• Portal/superior mesenteric vein: Possible during resection > suture, partial resection or end-to-end anastomosis
• Common/left/right hepatic artery: Possible in severe inflammation > patch, partial resection or end-to-end anastomosis
• Injury to the transverse mesocolon with impaired perfusion of the transverse colon: Quite rare > resection of the ischemic bowel segment and end-to-end anastomosis

Avoid intraoperative complications through careful dissection!