A small opening is made in the jejunal wall, with a size similar to the diameter of the main pancreatic duct. Suture threads with a needle on both sides are used to perform the anastomosis. The sutures are placed one by one, starting with the posterior suture-row. From inside the lumen of the main pancreatic duct, the needle is passed through the posterior pancreatic parenchyma, exiting the pancreas at the posterior side, approximately 0.5 cm away from the cut margin.
- Zhang L, Li Z, Wu X, Li Y, Zeng Z. Sealing pancreaticojejunostomy in combination with duct parenchyma to mucosa seromuscular one-layer anastomosis: A novel technique to prevent pancreatic fistula after pancreaticoduodenectomy. J Am Coll Surg. 2015;220:e71-e77.