One-layered invagination end-to-end pancreatojejunostomy2017-01-23T15:18:40+01:00

Using two transpancreatic sutures with buttresses

The pancreatic stump is invaginated into the jejunal loop, using traction sutures or other techniques. Two transpancreatic sutures with buttresses are inserted for fixation of the jejunal wall onto the intususcepted pancreatic remnant, using two suture-threads with a needle on […]

Purse-string suturing technique

The purse-string suturing-technique can be performed using a preloaded, reusable mechanical purse-string device, or can be hand-sewn, existing of a running suture. The purse-string is applied circumferentially to the cut end of the proximal jejunum. […]

Overlapping transpancreatic U-suturing technique

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 […]

With stripping of the proximal mucosa (mucosectomy)

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, […]

With inversion of the jejunum (telescoping technique)

An intestinal cuff is created by inverting the jejunal loop with a few sutures around the jejunal opening, before invaginating the pancreatic remnant into the jejunal lumen. Herewith, the cut surface of the pancreatic stump is covered by serosa instead […]


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 […]

One-layered technique

The pancreatic remnant is invaginated into the jejunal loop for 2-4 cm and sutured all around. Stitches are placed between the seromuscular coat of the jejunum and the pancreatic capsule. For invagination of the pancreatic stump, two traction sutures are placed across the superior […]