loisdaamen2017-08-16T15:11:16+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
A seromuscular incision is made in the posterior wall of the stomach, with a size similar to the diameter of the pancreatic stump; the mucosa is remained intact at first. The first hemstitch suture is applied in the seromuscular layer of the gastric wall around the seromuscular incision. […]
loisdaamen2017-08-27T22:08:57+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
Through the full-thickness of the posterior gastric wall, a transverse incision of 2 cm in length is made. A transverse full-thickness incision of 2 cm in length is applied in the anterior wall of the stomach, opposite to the posterior wall incision. […]
loisdaamen2017-08-16T15:10:16+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
A full-thickness incision is made in the posterior wall of the stomach, opposite to the pancreatic stump, with a size 1 cm less than the diameter of the pancreas. Around the incision, two seromuscular purse-string sutures are placed concentrically, respectively an inner and outer purse-string suture, about 1 cm apart from each other. […]
loisdaamen2017-08-16T15:08:58+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
The seromuscular layer of the posterior wall of the stomach is excised for a diameter that matches the diameter of the pancreatic stump. A single purse-string suture was placed around the seromuscular excision. Two traction sutures are placed on both sides of the pancreatic parenchyma next to the main pancreatic duct. […]
loisdaamen2017-08-16T15:08:29+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
An incision is made in de seromuscular layer of the posterior gastric wall, with a size comparable to the diameter of the pancreatic stump. Around the seromuscular incision, a purse-string suture is placed. The mucosal layer of the posterior gastric wall is incised a little smaller than the seromuscular incision. […]
loisdaamen2017-08-16T15:07:46+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
A gastrotomy with a size similar to the diameter of the pancreatic remnant is made in the posterior gastric wall. The pancreatic stump is inserted into the gastric lumen through the posterior gastrotomy. An outer suture-row is placed circumferentially, between the pancreatic capsule and the seromuscular layer of the gastric wall. […]
loisdaamen2017-08-16T15:07:02+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
A gastrotomy is made in the posterior wall of the stomach, with a size about 3/4 the width of the pancreatic remnant. Two traction sutures are placed on both ends of the pancreas. An anterior gastrotomy is performed, just above the posterior incision. Using the two traction sutures, the pancreatic stump is invaginated into the gastric lumen, through the posterior gastrotomy. […]
loisdaamen2017-08-16T15:05:57+02:00Technique pancreatogastrostomy-using-a-transgastric-approach|
A vertical incision with a size slightly less than the diameter of the pancreatic stump is made in the posterior wall of the stomach. Two traction sutures are placed on the superior and inferior sides of the pancreas. Either an anterior gastrotomy is performed or, in case of a classic Whipple, the clamp is temporarily removed from the transected stomach. […]
Dropstep2017-01-09T22:16:23+01:00Pancreatogastrostomy using a transgastric approach|
Techniques:
One-layered technique
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Using two transpancreatic sutures with buttresses
