Two-layered technique

A gastrotomy with a size similar to the diameter of the pancreatic remnant is made in the posterior gastric wall. The pancreatic stump is inserted into the gastric lumen through the posterior gastrotomy. An outer suture-row is placed circumferentially, between the pancreatic capsule and the seromuscular layer of the gastric wall.

Two-layered transgastric pancreatogastrostomy

  1. A gastrotomy with a size similar to the diameter of the pancreatic remnant is made in the posterior gastric wall.
  2. The pancreatic stump is inserted into the gastric lumen through the posterior gastrotomy.
  3. An outer suture-row is placed circumferentially, between the pancreatic capsule and the seromuscular layer of the gastric wall.
  4. A gastrotomy is performed in the anterior wall of the stomach.
  5. A second, inner suture-row is carried out from inside the gastric lumen, through the anterior gastrotomy, between the gastric mucosa and the parenchyma of the invaginated pancreas.
  6. The anterior gastrotomy is closed.

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