“Pancreatic fistulas and pancreatitis may develop in the pancreatic remnant and may lead to hemorrhage, sepsis, and subsequent death. Procedures to avoid pancreaticojejunostomy were described, including total pancreatectomy. None of these has so far proven to diminish morbidity significantly. Another technique investigated is obliteration closure of the pancreatic duct with a chemical substance, thus avoiding a pancreaticojejunostomy. This method was proposed by Gebhardt et al. They studied the effect of occlusion of the pancreatic duct system with Ethibloc, an alcoholic prolamine, in animal experiments. The pancreatic duct may also be occluded with a fibrin glue solution, Tissucol, which was found to have a more protective effect on beta cell function than the other solutions used.”

“Failure of a surgical anastomosis has serious consequences, particularly in case of anastomosis of the pancreas to the small bowel, because of the digestive capacities of
activated pancreatic secretions. An important factor in the prevention of pancreatic fistula in patients with a pancreaticojejunostomy is technical precision and gentleness in construction of the pancreatic anastomosis. A dilated pancreatic duct in a fibrotic pancreas may decrease the incidence of postoperative fistula”

“In conclusion, there are no advantages in avoiding a pancreaticojejunostomy. Duct obliteration without anastomosis does not reduce postoperative complications. A pancreatic surgeon must be able to perform more than one technique for managing the pancreatic remnant, especially in the case of a small pancreatic duct and a soft friable pancreatic remnant. The method of choice remains a pancreaticoenterostomy because of the significantly higher risk of endocrine insufficiency in case of duct occlusion.”

Tran, Khe et al. “Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial.” Annals of surgery vol. 236,4 (2002): 422-8; discussion 428. Free Full Text