What is the jejunum reattached to during a Whipple procedure?

During a Whipple procedure, also known as a pancreaticoduodenectomy, the jejunum is primarily reattached to the pancreatic stump and the hepatic duct. The procedure entails the resection of the head of the pancreas, the duodenum, a portion of the bile duct, and sometimes the gallbladder, followed by a reconstruction phase that restores continuity of the gastrointestinal tract.

Specifically, the jejunum is anastomosed to the remaining pancreatic tissue where digestive enzymes are produced, facilitating proper digestion. Additionally, since the bile duct typically drains into the duodenum, it is also connected to the jejunum during the reconstruction via a separate anastomosis, allowing bile to enter the jejunum and aid in fat digestion.

The other choices do not accurately represent the reconstruction process. For instance, reattaching the jejunum to the ascending colon or pylorus would not provide the necessary digestive enzymes and bile required for effective nutrient absorption following pancreatic and duodenal loss. The reconstruction focuses on restoring the continuity of the digestive system from the jejunum to both the pancreatic stump and the hepatic duct, ensuring that nutrients can be properly processed after surgery.