With seromuscular incision

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  1. A seromuscular incision is made in the posterior gastric wall, with a size comparable to the diameter of the pancreatic remnant.
  2. A small mucosal incision in the centre of the incised seromuscular layer, opposite of the main pancreatic duct.
  3. An outer suture-line is performed between the anterior pancreatic capsule and the seromuscular cut edge of the posterior gastric wall first.
  4. 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.
  5. 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.