With seromuscular incision
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- A seromuscular incision is made in the posterior gastric wall, with a size comparable to the diameter of the pancreatic remnant.
- A small mucosal incision in the centre of the incised seromuscular layer, opposite of the main pancreatic duct.
- An outer suture-line is performed between the anterior pancreatic capsule and the seromuscular cut edge of the posterior gastric wall first.
- Second, the main pancreatic duct is sutured circumferentially to the mucosa around the small opening in the posterior stomach wall to form the inner, duct-to-gastric-mucosa suture-row.
- The anastomosis is completed by finishing the outer suture-row between the posterior pancreatic capsule and the seromuscular cut edge of the posterior gastric wall.
One-layered technique
DILL-RUSSELL AS. Pancreaticogastrostomy. Lancet. 1952;1:589-590
Gupta S. Pancreaticogastrostomy: A simplified technique. J Surg Oncol. 1994;56:249-250.
Using two transpancreatic sutures with buttresses
Lee JY, Kim EY, Lee JS, et al. A novel pancreaticogastrostomy method using only two transpancreatic sutures: early postoperative surgical results compared with conventional pancreaticojejunostomy. Ann Surg Treat Res. 2015;88:299-305.