A simpler and more reliable technique of pancreatojejunal anastomosis

Abstract

We herein describe the technical aspects of our method for end-to-side style pancreatojejunal anastomosis which we have been using when performing the Whipple procedure without any anastomotic complications. The method is simple and can be applied wherever an end-to-side pancreatojejunal anastomosis is required. It consists of three steps: First, a drainage tube is inserted into the pancreatic duct. Second, a direct anastomosis between the pancreatic duct and the mucosal layer of the jejunal loop is performed. The third step, which is the unique aspect of our method, is an approximation of the jejunal wall and the pancreatic stump by a one-layer suture technique that allows us not only to reduce the number of sutures but also to eliminate some of the sophisticated manipulations required by other methods. The results of our clinical experience have indicated that the present method may be comparable in terms of technical reliability to other existing methods.