One purse-string suture and two U-shaped mattress sutures

Opposite to the pancreatic stump, the jejunal wall is incised for ca. 2 cm. A seromuscular purse-string suture is performed around the new-formed opening, about 0.5 cm away from the cut edge. Next, two U-shaped mattress sutures are placed at both sides of the main pancreatic duct.

Two-layered invagination end-to-side pancreatojejunostomy using one purse-string suture and two U-shaped mattress sutures

  1. Opposite to the pancreatic stump, the jejunal wall is incised for ca. 2 cm.
  2. A seromuscular purse-string suture is performed around the new-formed opening, about 0.5 cm away from the cut edge.
  3. Next, two U-shaped mattress sutures are placed at both sides of the main pancreatic duct.
  4. After tying the mattress sutures, the pancreatic remnant is invaginated into the jejunum.
  5. The mucosa of the bowel wall is inverted into the jejunal lumen to provide contact between the pancreatic capsule and the serosal surface of the jejunum.
  6. Finally, the purse-string suture is tied.

  • Kelemen D, Papp R, Kaszás B, Bíró Z, Vereczkei A. Pancreatojejunostomy with modified purse-string suture technique. Langenbeck’s Arch Surg. 2016:1-5.