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Thilo Hackert, MD, Vladimir J

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1 Teres Hepatis Ligament Flap Plasty to Prevent Pancreatic Fistula after Tumor Enucleation 
Thilo Hackert, MD, Vladimir J. Lozanovski, MD, Jens Werner, MD, MBA, Markus W. Büchler, MD, Peter Schemmer, MD, MBA  Journal of the American College of Surgeons  Volume 217, Issue 4, Pages e29-e34 (October 2013) DOI: /j.jamcollsurg Copyright © 2013 American College of Surgeons Terms and Conditions

2 Figure 1 Situs prior to complete tumor enucleation of a pancreatic tumor lesion localized in the pancreatic body. Journal of the American College of Surgeons  , e29-e34DOI: ( /j.jamcollsurg ) Copyright © 2013 American College of Surgeons Terms and Conditions

3 Figure 2 Tumor bed after tumor enucleation. Blood coagulation is achieved by clipping and thermocoagulation. Journal of the American College of Surgeons  , e29-e34DOI: ( /j.jamcollsurg ) Copyright © 2013 American College of Surgeons Terms and Conditions

4 Figure 3 Closure of parenchyma and capsule using atraumatic sutures.
Journal of the American College of Surgeons  , e29-e34DOI: ( /j.jamcollsurg ) Copyright © 2013 American College of Surgeons Terms and Conditions

5 Figure 4 Tumor specimen of a well-differentiated endocrine pancreatic tumor with a diameter of 1.6 cm enucleated in sano. Journal of the American College of Surgeons  , e29-e34DOI: ( /j.jamcollsurg ) Copyright © 2013 American College of Surgeons Terms and Conditions

6 Figure 5 The skeletonized teres hepatis ligament pedicle flap is sufficiently mobilized and guided through a window in the lesser omentum (retrogastrally) toward the pancreatic tissue defect. Journal of the American College of Surgeons  , e29-e34DOI: ( /j.jamcollsurg ) Copyright © 2013 American College of Surgeons Terms and Conditions

7 Figure 6 Teres hepatis ligament transposed on the previously closed enucleation site and fixated with atraumatic suture. Journal of the American College of Surgeons  , e29-e34DOI: ( /j.jamcollsurg ) Copyright © 2013 American College of Surgeons Terms and Conditions

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