Using two vertical mattress sutures

2017-08-16T15:28:25+02:00Technique triple-layered duct-to-mucosa end-to-side pancreatojejunostomy|

Before the pancreatic anastomosis is performed, two vertical mattress sutures are applied on both sides of the main pancreatic duct, to consolidate the pancreas. Suture-threads with straight needles are used. The sutures are placed 2-3 mm away from the pancreatic cut end and penetrate the complete pancreatic parenchyma. Care is taken to avoid injury to the main pancreatic duct. The vertical mattress sutures are tied firmly. […]

Triple-layered technique

2017-08-16T15:27:16+02:00Technique triple-layered duct-to-mucosa end-to-side pancreatojejunostomy|

The first layer of sutures exists of an approximation between the capsule of the pancreatic remnant and the jejunal serosa posteriorly. The seromuscular coat of the jejunum is incised for a length with the same size as the diameter of the pancreatic stump. The posterior second suture-row is performed between the pancreatic cut end and the extramucosal or seromuscular layer of the jejunum. […]