Using two vertical mattress sutures
- Before the pancreatic anastomosis is performed, two vertical mattress sutures are applied on both sides of the main pancreatic duct, to consolidate the pancreas. Suture-threads with straight needles are used. The sutures are placed 2-3 mm away from the pancreatic cut end and penetrate the complete pancreatic parenchyma. Care is taken to avoid injury to the main pancreatic duct. The vertical mattress sutures are tied firmly.
- A triple-layered duct-to-mucosa end-to-side pancreatojejunostomy is performed as described above, however, the first (most outer) row of sutures is carried out between the serosal layer of the jejunal wall and the preplaced mattress sutures.