Mucosectomy of the distal jejunum can be performed before invagination of the pancreatic stump. The mucosal layer of the jejunum is exposed by everting the distal part of the jejunum for about 3 cm. This can be done using two sutures, placed between the seromuscular coat near the jejunal cut end and the jejunal wall about 6 cm away from the cut margin.

One-layered invagination end-to-end pancreatojejunostomy with stripping of the proximal mucosa (mucosectomy)

  1. Mucosectomy of the distal jejunum can be performed before invagination of the pancreatic stump.
  2. The mucosal layer of the jejunum is exposed by everting the distal part of the jejunum for about 3 cm. This can be done using two sutures, placed between the seromuscular coat near the jejunal cut end and the jejunal wall about 6 cm away from the cut margin.
  3. The exposed mucosa is excised (mucosectomy).
  4. The pancreatic stump is brought together with the jejunal free margin and the everted part of the jejunum is folded back by cutting the two formerly placed stitches. Herewith, the pancreatic remnant is invaginated and surrounded by the seromuscular layer of the jejunum.
  5. The cut end of the jejunum is sutured to the pancreatic capsule with a single suture-row.

  • Li P, Mao Q, Li R, et al. Telescopic technique associated with mucosectomy: a simple and safe anastomosis in pancreaticoduodenectomy. Am J Surg. 2011;201:e29-31.