A posterior outer suture-row is carried out between the seromuscular coat of the jejunum and the pancreatic capsule. A full-thickness incision is made in the side wall of the jejunum, opposite to the pancreatic remnant and a few cm away from the jejunal stump, with a size similar to the diameter of the pancreas.

Two-layered invagination end-to-side pancreatojejunostomy

  1. A posterior outer suture-row is carried out between the seromuscular coat of the jejunum and the pancreatic capsule.
  2. A full-thickness incision is made in the side wall of the jejunum, opposite to the pancreatic remnant and a few cm away from the jejunal stump, with a size similar to the diameter of the pancreas.
  3. A inner layer of sutures is performed circumferentially, anastomosing the cut edge of the pancreas to the full-thickness of the jejunal wall.
  4. Finally, the jejunum is pulled over the anterior inner layer and is fixed onto the pancreatic capsule, completing the outer suture-row anteriorly. This causes invagination of the pancreas into the jejunal lumen through the jejunal sidewall.

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