The seromuscular layer of the first 2-3 cm of the jejunal cut end is removed before the anastomosis is performed, preserving the jejunal mucosa. The pancreatic capsule, about 2 cm away from the cut margin, is anastomosed to the seromuscular coat of the jejunum posteriorly.
Two-layered invagination end-to-end pancreatojejunostomy with stripping of the proximal seromuscular layer
- The seromuscular layer of the first 2-3 cm of the jejunal cut end is removed before the anastomosis is performed, preserving the jejunal mucosa.
- The pancreatic capsule, about 2 cm away from the cut margin, is anastomosed to the seromuscular coat of the jejunum posteriorly.
- Sutures are circumferentially placed between the edge of the pancreatic stump and the preserved mucosal edge of the jejunum.
- The anastomosis is completed by performing an anterior outer suture-row between the anterior sides of the pancreatic capsule and seromuscular layer of the jejunum, causing invagination of the first 2 cm of the pancreas into the jejunum.
- Maki HS, Kolts RL, Kuehner ME. Prevention of pancreatic fistula by modified pancreaticojejunal anastomosis. Am J Surg. 1990;160:533-534.
- Pedrazzoli S, Sperti C, Pasquali C. An easier technique for end to end pancreaticojejunostomy. HPB Surg. 1996;9:141-143.
