The pancreatic stump is invaginated into the jejunal loop, using traction sutures or other techniques. Two transpancreatic sutures with buttresses are inserted for fixation of the jejunal wall onto the intususcepted pancreatic remnant, using two suture-threads with a needle on both strain ends.

One-layered invagination end-to-end pancreatojejunostomy using two transpancreatic sutures with buttresses

  1. The pancreatic stump is invaginated into the jejunal loop, using traction sutures or other techniques.
  2. Two transpancreatic sutures with buttresses are inserted for fixation of the jejunal wall onto the intususcepted pancreatic remnant, using two suture-threads with a needle on both strain ends.
  3. One suture is placed on the superior side and one on the inferior side, about 2 cm away from the cutting edges, on both sides of the main pancreatic duct. The sutures are passed through the covering jejunal wall on the anterior side, penetrating the full-thickness of the invaginated pancreas, and brought outside through the posterior jejunal wall.
  4. Care should be taken to avoid injury to the main pancreatic duct.
  5. The four buttresses (two on each side) are placed via the needles and the sutures are tied.

  • Kim EY, You YK, Kim DG, Hong TH. A simple pancreaticojejunostomy technique for hard pancreases using only two transpancreatic sutures with buttresses: a comparison with the previous pancreaticogastrostomy and dunking methods. Ann Surg Treat Res. 2016;90:64-71.