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Before the pancreatojejunal anastomosis is performed, the walls of the main pancreatic duct at the cut end are everted and sutured to the periductal pancreatic parenchyma circumferentially. This is done by placing each needle from the cut surface of the pancreas just around the main duct, through the periductal parenchyma and ductal wall 2-3 mm away from the cut end, and outwards via the ductal lumen. The pancreatic duct is everted by tying these sutures away from the duct, at the insertion place on the cut surface of the pancreas.
Any technique for pancreatojejunal anastomosis can be used to restore the pancreatoenteric continuity.
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.
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