Two-layered duct-to-mucosa end-to-side pancreatojejunostomy

Two-layered duct-to-mucosa end-to-side pancreatojejunostomy2017-01-23T15:12:49+01:00

Duct-to-mucosa technique

An incision is made in the seromuscular layer of the jejunal wall, comparable with the size of the pancreatic stump. Sutures are placed between the posterior edge of the seromuscular jejunal incision and the posterior pancreatic capsule to form the […]

Whole-layer tightly appressed

The pancreatic capsule is sutured to the seromuscular wall of the jejunum posteriorly, about 1 cm away from the pancreatic cut end. A small hole, with a diameter that matches the diameter of the main pancreatic duct, is […]

Purse-string suturing technique

The seromuscular layer of the jejunum is incised with a width comparable to the diameter of the pancreatic remnant. A purse-string suture is performed in the mucosa at the centre of the seromuscular incision. A stent tube […]

Pair watch suturing technique

The pair watch suturing technique contains a precise way of accomplishing a duct-to-mucosa pancreatojejunostomy, by imaging the faces of a pair of wristwatches on the jejunal hole and the main pancreatic duct during the anastomosis procedure. A small […]

Kakita method

A small incision in made through the full-thickness of the jejunal wall, with the same diameter as the main pancreatic duct. An inner suture-row is circumferentially performed with 3-4 sutures, placed between the main pancreatic duct an the […]

Blumgart anastomosis

An opening is made in the seromuscular side wall of the jejunum, with a size similar to the diameter of the pancreas. The Blumgart anastomosis is constructed by four to six transpancreatic U-sutures: two to three on each […]

True duct-to-mucosa anastomosis

An outer, posterior suture-row is performed between the outer 2/3rd of the radius of the cut pancreatic gland and the seromuscular layer of the jejunal wall posteriorly. A small hole of 2-3 mm in diameter is made through the […]

In case of a small pancreatic duct

A posterior outer suture-row is performed between the capsule of the pancreatic stump and the seromuscular layer of the jejunum posteriorly. Opposite to the main pancreatic duct, a full-thickness incision with a length of 1 cm is made […]


Before the pancreatojejunal anastomosis is started, the pancreatic stump is ‘closed’. For this procedure, a stent tube is placed into the main pancreatic duct, and the cut surface of the pancreatic stump is shaped like a ‘fish-mouth’. The two […]