Pancreaticojejunostomy Technique
Pancreaticojejunostomy Technique - Related Videos
07:49
Colonial Wig Pancreaticojejunostomy
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2019
We describe a new technique for pancreaticojejunostomy reconstruction after pancreaticoduodenectomy that is associated with a very low rate of postoperative pancreatic fistula.
11:07
Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis
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2025
This protocol presents a method for performing a parenchymal sparing robotic-assisted lateral pancreaticojejunostomy intended for appropriately selected patients with a pancreatic duct obstruction without significant inflammation of the pancreatic head. This article demonstrates critical aspects of the operation in a minimally invasive, robotic fashion to treat recurrent acute/chronic pancreatitis.
08:57
Laparoscopic Pancreatoduodenectomy With Modified Blumgart Pancreaticojejunostomy
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Cited by 17 •
2018
Laparoscopic pancreatoduodenctomy (LPD) may offer advantages over open pancreatoduodenectomy, including early postoperative mobilization, less delayed gastric emptying and a shorter hospital stay. However, LPD is technically challenging and not well-standardized, especially regarding the pancreatic anastomosis. We describe a standardized technique for the pancreatic anastomosis during LPD: modified Blumgart pancreaticojejunostomy.
08:10
Robotic Lateral Pancreaticojejunostomy for Chronic Pancreatitis
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Cited by 9 •
2019
Robotic lateral pancreaticojejunostomy (RLPJ) may be used in patients with painful, morphine dependent, chronic pancreatitis and a dilated main pancreatic duct. We describe a standardized and reproducible technique for RLPJ, which includes transection of the gastroduodenal artery.
10:34
Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
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Cited by 7 •
2021
Robotic central pancreatectomy may be used in selected patients in experienced centers. This protocol presents all steps and the feasibility of a robotic central pancreatectomy with Roux-en-Y pancreaticojejunostomy in a 16-year-old adolescent patient.
FAQs
Accurate alignment brings the pancreatic duct into continuity with the jejunal wall so pancreatic secretions can pass into the digestive tract. This relationship is central to maintaining exocrine drainage after resection. A well-aligned connection also supports the broader surgical goal of limiting leakage, fistula formation, and other postoperative complications.
The two approaches create the reconstruction through different tissue arrangements. Duct-to-mucosa repair directly aligns the pancreatic duct with the intestinal mucosa, whereas invagination places the pancreatic remnant into the jejunal lumen. Both approaches are secured with sutures and are intended to preserve drainage while reducing the risk of an inadequate anastomosis.
An internal stent may support the connection between the pancreatic duct and jejunum during reconstruction. Its use is optional rather than universal, and it supplements the sutured anastomosis rather than replacing accurate tissue alignment. When included, the stent is part of the technical strategy for supporting pancreatic secretions as they enter the digestive tract.
The reconstructed junction must maintain pancreatic drainage without allowing secretions to escape around the anastomosis. Leakage can contribute to fistula formation and related postoperative complications. For that reason, surgeons emphasize careful duct and intestinal-wall alignment, secure suturing, and an appropriate reconstruction method to support a sound connection after pancreatic resection.
The reconstruction begins by positioning the pancreatic remnant alongside the jejunum and aligning the pancreatic duct with the intestinal wall. Surgeons then create either a duct-to-mucosa or invagination anastomosis, secure the tissues with sutures, and may add an internal stent. These steps establish a route for pancreatic secretions while supporting postoperative reconstruction.
Pancreaticojejunostomy is most often used during pancreaticoduodenectomy, when reconstruction is required after pancreatic resection. It also applies to other operations that disrupt the normal route of pancreatic drainage. In hepatopancreatobiliary surgery and surgical training, the technique provides a focused example of how reconstruction can preserve exocrine flow while addressing postoperative risks.