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
- 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.
- An anterior gastrotomy is performed.
- 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.
- The pancreas is invaginated into the gastric cavity through the posterior gastrotomy.
- Both the outer and inner purse-string sutures are tied (respectively outer seromuscular binding and inner mucosal binding).
- 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.
