New Technique of Pancreaticojejunostomy During Whipple Operation

A traditional pancreaticoduodenectomy with pylorus preservation was performed on each patient. A pancreaticojejunostomy was created by double-layered, end-to-side, duct-to-mucosa anastomosis between the primary pancreatic duct and jejunal wall without stenting or omental patch.

A traditional pancreaticoduodenectomy with pylorus preservation was performed on each patient. A pancreaticojejunostomy was created by double-layered, end-to-side, duct-to-mucosa anastomosis between the primary pancreatic duct and jejunal wall, a nelaton stent 6f was inserted into the pancreatic duct and jejunum of each patient receiving PJ. The larger omentum was separated longitudinally over an avascular zone, and one or two omental branches of the gastroepiploic arteries were preserved using pedicle omental flaps. The omental flap was pushed between the posterior surface of PJ and the portal vein, then wrapped over the anterior surface of PJ. The omentum was rolled up and secured with a few PDS sutures.