Purse-string suturing technique

The purse-string suturing-technique can be performed using a preloaded, reusable mechanical purse-string device, or can be hand-sewn, existing of a running suture. The purse-string is applied circumferentially to the cut end of the proximal jejunum.

One-layered invagination end-to-end pancreatojejunostomy using a purse-string suture

  1. The purse-string suturing-technique can be performed using a preloaded, reusable mechanical purse-string device, or can be hand-sewn, existing of a running suture.
  2. The purse-string is applied circumferentially to the cut end of the proximal jejunum.
  3. The pancreatic remnant is invaginated into the jejunal loop. This can be done using traction sutures.
  4. The purse-string is tightened snugly around the pancreatic stump. Additional sutures can be placed between the jejunual cut edge and the pancreatic capsule, incorporating the purse-string.

  • Celis J, Berrospi F, Ruiz E, Payet E. Safe pancreaticojejunostomy after Whipple procedure: modified technique. J Surg Oncol. 2001;76:138-140.
  • Murr MM, Nagorney DM. An end-to-end pancreaticojejunostomy using a mechanical purse-string device. Am J Surg. 1999;177:340-341.
  • Nordback I, Raty S, Laukkarinen J, et al. A novel radiopaque biodegradable stent for pancreatobiliary applications–the first human phase I trial in the pancreas. Pancreatology. 2012;12:264-271.