One-layered anteriorly and two-layered posteriorly

The anastomosis between the pancreas and jejunum is performed using two layers of sutures posteriorly and one anterior suture-row. First, the outer posterior layer is performed by placing sutures between the capsule and some parenchyma of the pancreatic remnant and the seromuscular layer of the jejunal wall.

One-layered anteriorly and two-layered posteriorly invagination end-to-side pancreatojejunostomy

  1. The anastomosis between the pancreas and jejunum is performed using two layers of sutures posteriorly and one anterior suture-row.
  2. First, the outer posterior layer is performed by placing sutures between the capsule and some parenchyma of the pancreatic remnant and the seromuscular layer of the jejunal wall.
  3. An incision is made through the full-thickness of the jejunum with a size similar to the diameter of the pancreas.
  4. Stitches are placed between the jejunal mucosa and the pancreatic parenchyma to form a posterior inner suture-row.
  5. Anteriorly, a single layer of stitches is performed between the pancreatic capsule and parenchyma and the seromuscular wall of the jejunal loop. Herewith, the pancreatojejunostomy is completed.

  • Testini M, Piccinni G, Greco L, et al. A modified technique of pancreaticojejunostomy after pancreatoduodenectomy: a preliminary experience. Updates Surg. 2011;63:287-291.