[Four Stitches Duct-to-Mucosa Pancreatojejunostomy]

Recently, modified Blumgart pancreaticojejunostomy has been reported. In this method, close suture of the pancreatic parenchyma and jejunal serosal muscle layer is considered to be important. On the other hand, there is no settled method for anastomosis of the pancreatic duct and jejunum. There are reports of 6 to 12 stitches for anastomosis of the pancreatic duct and jejunum depending on the diameter of the pancreatic duct, but there are no reports of 4 stitches for anastomosis of the pancreatic duct and jejunum(hereafter referred to as the 4-stitches method), which is a simpler method. The pancreatic jejunal anastomosis was performed by the 4 stitches method in 22 patients regardless of the diameter of the pancreatic duct. 21 patients had postoperative pancreatic fistula Grade(ISGPS classification)of Grade A or less, and 1 patient had Grade B. The important features of the 4 stitches method are that the pancreatic duct and jejunum can easily be attached as a plane and the drainage hole is not easily narrowed. I think that the technique is simple and easily reproducible anastomosis method.