Binding pancreatogastrostomy

An incision is made in de seromuscular layer of the posterior gastric wall, with a size comparable to the diameter of the pancreatic stump. Around the seromuscular incision, a purse-string suture is placed. The mucosal layer of the posterior gastric wall is incised a little smaller than the seromuscular incision.

 

Binding pancreatogastrostomy

  1. An incision is made in de seromuscular layer of the posterior gastric wall, with a size comparable to the diameter of the pancreatic stump.
  2. Around the seromuscular incision, a purse-string suture is placed.
  3. The mucosal layer of the posterior gastric wall is incised a little smaller than the seromuscular incision.
  4. An anterior gastrotomy is performed.
  5. Through the anterior gastrotomy, a mucosal tube is formed by pulling the edge of the mucosal incision to inside the gastric cavity, and a second purse-string suture is placed around the mucosal opening from within the gastric lumen.
  6. The pancreas is invaginated into the gastric cavity through the posterior gastrotomy.
  7. Both the outer and inner purse-string sutures are tied (respectively outer seromuscular binding and inner mucosal binding).
  8. The anterior gastrotomy is closed.

  • Peng SY, Wang JW, Hong de F, Liu YB, Wang YF. Binding pancreaticoenteric anastomosis: from binding pancreaticojejunostomy to binding pancreaticogastrostomy. Updates Surg. 2011;63:69-74.