Overlapping transpancreatic U-suturing technique

2017-08-16T14:19:01+00:00 Technique one-layered-invagination-end-to-end-pancreatojejunostomy|

The pancreatic stump is invaginated into the jejunal lumen by two to three transpancreatic U-sutures, overlapping each other. The first U-suture is started at the mesenteric side of the anterior jejunum. This suture penetrates the jejunal wall from outside to inside about 1 cm distal to the cut edge and is then withdrawn from the jejunal opening. […]

With stripping of the proximal mucosa (mucosectomy)

2017-08-16T14:19:55+00:00 Technique one-layered-invagination-end-to-end-pancreatojejunostomy|

Mucosectomy of the distal jejunum can be performed before invagination of the pancreatic stump. The mucosal layer of the jejunum is exposed by everting the distal part of the jejunum for about 3 cm. This can be done using two sutures, placed between the seromuscular coat near the jejunal cut end and the jejunal wall about 6 cm away from the cut margin. […]

Mesh-reinforced

2017-08-16T14:23:01+00:00 Modifications one-layered-invagination-end-to-end-pancreatojejunostomy, Technique one-layered-invagination-end-to-end-pancreatojejunostomy|

The edge of the stump is tightly wrapped around using an absorbable or non-absorbable mesh with a width of 1.0-1.5 cm and a length that matches the circumferential length of the pancreas. The mesh is placed about 1.0 cm from the cut margin of the pancreas and can be fixed onto the pancreatic capsule with a few stitches. […]