Litmus Paper Helps Detect Potential Pancreatoenterostomy Leakage

Background: Leakage of pancreatoenterostomy remains as a serious and fatal complication after pancreatectomy. Several risk factors have been reported, ie, normal pancreatic parenchyma, small pancreatic duct, a large amount of intraoperative blood loss, management of the cut surface of the pancreas, and the presence of preoperative jaundice. Transected pancreatic ductules on the cut surface of the pancreas that are not drained into the main pancreatic duct after pancreatectomy are one of the risks. The pancreatic juice is alkaline and turns red litmus to blue. Methods: In order to detect the transected pancreatic ductules on the cut surface of the pancreas, red litmus paper is applied to the cutting surface of the pancreas after stimulation of secretin. Results: Nondrained, transected pancreatic ductules on the cut surface of the pancreas can be detected as blue spots on the red litmus paper. The corresponding areas to the blue spots can be transfixed with sutures to close the non-drained and transected pancreatic ductules. Conclusion: Litmus paper can be expected to detect pancreatoenterostomy leakage after pancreatectomy.