loisdaamen2017-08-16T15:23:05+02:00Technique two-layered duct-to-mucosa end-to-side pancreatojejunostomy|
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. […]
loisdaamen2020-04-09T14:06:44+02:00Technique duct-to-mucosa, Technique two-layered duct-to-mucosa end-to-side pancreatojejunostomy|
An opening is made in the seromuscular side wall of the jejunum, with a size similar to the diameter of the pancreas. The Blumgart anastomosis is constructed by four to six transpancreatic U-sutures: two to three on each side of the main pancreatic duct. Suture-threads with a needle on both ends are used. […]
loisdaamen2017-08-16T15:21:01+02:00Technique two-layered duct-to-mucosa end-to-side pancreatojejunostomy|
An outer, posterior suture-row is performed between the outer 2/3rd of the radius of the cut pancreatic gland and the seromuscular layer of the jejunal wall posteriorly. A small hole of 2-3 mm in diameter is made through the full-thickness of the jejunal wall, opposite the main pancreatic duct. The jejunal mucosa is everted in all directions and anchored to the seromuscular wall around the new-formed opening in the jejunum, using four stitches. […]
loisdaamen2017-08-16T15:20:28+02:00Technique two-layered duct-to-mucosa end-to-side pancreatojejunostomy|
A posterior outer suture-row is performed between the capsule of the pancreatic stump and the seromuscular layer of the jejunum posteriorly. Opposite to the main pancreatic duct, a full-thickness incision with a length of 1 cm is made in the jejunal wall. The cut surface of the pancreatic remnant is anastomosed to the seromuscular edges of the new-formed jejunal opening. […]
loisdaamen2017-08-16T15:19:37+02:00Technique two-layered duct-to-mucosa end-to-side pancreatojejunostomy|
Before the pancreatojejunal anastomosis is started, the pancreatic stump is ‘closed’. For this procedure, a stent tube is placed into the main pancreatic duct, and the cut surface of the pancreatic stump is shaped like a ‘fish-mouth’. The two lips of the fish-mouth are sutured together, closing the cut end of the pancreas, with exclusion of the pancreatic duct. […]
loisdaamen2017-01-23T10:37:23+01:00Geen categorie|
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loisdaamen2017-08-16T15:31:58+02:00Technique two-layered-invagination-end-to-side-pancreatojejunostomy|
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.
loisdaamen2017-08-16T15:30:34+02:00Technique two-layered-invagination-end-to-side-pancreatojejunostomy|
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.
loisdaamen2017-08-16T15:30:19+02:00Technique two-layered-invagination-end-to-side-pancreatojejunostomy|
An incision is made in the jejunal side wall with a size that matches the diameter of the pancreatic stump. At least three stitches are preplaced in both the posterior and anterior walls of the main pancreatic duct. The inner suture-row is circumferentially performed between the full-thickness of the jejunum and the pancreatic parenchyma of the cut edge; the six formerly placed ductal sutures are integrated in the posterior and anterior parts of the inner suture-line (respectively three in the posterior part and three in the anterior part).
loisdaamen2017-08-16T15:29:16+02:00Technique two-layered-invagination-end-to-side-pancreatojejunostomy|
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. […]
