[Pancreaticoduodenectomy with Pancreaticogastric Anastomosis for Jehovah's Witness Patients].

Abstract

Background: Jehovah's Witnesses followers may have limited treatment options because they do not accept blood transfusion therapy for religious reasons. In addition, pancreatoduodenectomy is known to carry a high risk of intra-abdominal bleeding due to postoperative pancreatic fistula. Our hospital has a policy of providing surgical treatment to Jehovah's Witnesses whenever possible, and we perform pancreaticoduodenectomy with pancreaticogastric anastomosis in the belief that it is less likely to cause fatal complications in the short term.

Subject: Four pancreaticoduodenectomies were performed on Jehovah's Witness believers between November 2017 and May 2024. The diseases were IPMC, ampullary carcinoma, cholangiocarcinoma, and duodenal carcinoma in one case each. All patients underwent reconstruction with gastro-pancreatic anastomosis.

Results: All patients completed the treatment without blood transfusion. Operation time: 514 minutes, blood loss: 290 mL. Postoperative hospital stay was 40 days. Intra-abdominal abscess was observed in one patient, but there were no hemorrhagic complications and no in-hospital death.

Conclusion: Pancreaticoduodenectomy with pancreaticogastric anastomosis for Jehovah's Witnesses patient at our hospital was considered acceptable.