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. […]
