One layer end-to-side pancreaticojejunostomy using reinforcing suture on the pancreatic stump

Yong Jin Kwon, Byung Kyu Ahn, Hwon Kyum Park, Kwang Soo Lee, Kyeong Geun Lee

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Background/Aims: Pancreaticoduodenectomy is associated with a high incidence of postoperative morbidity, and pancreatic fistulas are the most important complication. We therefore designed a modified method of pancreaticojejunostomy using reinforcing suture on the pancreatic stump. Methodology: The procedure is performed as follow: first, insert a soft rubber catheter into the pancreatic duct, then make reinforcing sutures with 3-0 vicryl. These sutures are parallel to the cut edge of the pancreatic stump, and 5mm from the cut edge. The whole layer of jejunum is sewed to the pancreas including the reinforcing sutures. Results: Between July 2002 and November 2011, 52 consecutive cases of pancreaticoduodenectomy were performed using this method. We used The International Study Group for Pancreatic Surgery (ISGPS) severity grading for postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE). There was 1 grade A fistula (1.9%), 16 grade B fistulas (30.8%), and 2 grade C fistulas (3.8%). Conclusions: This method of one layer anastomosis is straightforward and practicable; hence it saves operative time, and is not much affected by lack of familiarity with the surgical technique. Even if it does not actually prevent pancreatic fistula formation, it does prevent the life-threatening complete breakdown of the pancreaticojejunostomy.

Original languageEnglish
Pages (from-to)1488-1491
Number of pages4
Issue number126
StatePublished - 2013 Sep


  • Pancreatic fistula
  • Pancreaticoduodenectomy
  • Pancreaticojejunostomy
  • Reinforcing suture


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