Kakita method

A small incision in made through the full-thickness of the jejunal wall, with the same diameter as the main pancreatic duct. An inner suture-row is circumferentially performed with 3-4 sutures, placed between the main pancreatic duct an the full-thickness of the jejunal wall.

Kakita pancreatojejunostomy (transfixing suturing technique)

  1. A small incision in made through the full-thickness of the jejunal wall, with the same diameter as the main pancreatic duct.
  2. An inner suture-row is circumferentially performed with 3-4 sutures, placed between the main pancreatic duct an the full-thickness of the jejunal wall.
  3. For the outer layer, a so-called ‘transfixing suturing technique’ is used: from anterior to posterior, 6-8 sutures go straight through the pancreatic parenchyma. Each needle passes through the seromuscular layer of the jejunum superficially, widely enough the cover the pancreatic stump. Care is taken to achieve complete coverage of the pancreatic cut edge by the seromuscular jejunal wall.

Modifications of the Kakita method contain variations in the amount of sutures used for the inner and outer suture-rows.

  • Oda T, Hashimoto S, Miyamoto R, et al. The Tight Adaptation at Pancreatic Anastomosis Without Parenchymal Laceration: An Institutional Experience in Introducing and Modifying the New Procedure. World J Surg. 2015;39:2014-2022.
  • Satoi S, Toyokawa H, Yanagimoto H, et al. A new guideline to reduce postoperative morbidity after pancreaticoduodenectomy. Pancreas. 2008;37:128-133.
  • Tajima Y, Kuroki T, Tsuneoka N, et al. Anatomy-specific pancreatic stump management to reduce the risk of pancreatic fistula after pancreatic head resection. World J Surg. 2009;33:2166-2176.

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