Combined Duct-to-Mucosa and Dunking Pancreatojejunostomy Technique

Abstract

Summary: This video demonstrates a Duct-to-Mucosa combined with Dunking pancreatojejunostomy technique. We open the jejunum on the antimesenteric side approximately in similar size to pancreatic duct. Then we start to approximate the pancreas to the jejunum by stitching the posterior side of the duct to the posterior side of the intestine hole in all-layer manner. Afterwards, we stitched the pancreas parenchyma to the seromuscular layer of jejunum. Often, due to a very small-size duct, we found difficulties in doing the same technique on the anterior side. That is why we try different technique on the anterior side, Dunking technique. This combined technique ease surgeons to perform pancreaticojejunostomy especially on firm and stiff pancreas.