Double Duct to Mucosa Pancreaticojejunostomy for Bifid Pancreatic Duct following Pylorus Preserving Pancreaticoduodenectomy: A Case Report

Scheme 1

This scheme demonstrates the adaptation of the cut edge of the jejunum to the surface of the dorsal pancreatic remnant at the time of completion of the posterior inner row of the two-layer, single-stich (with monofilament absorbable, PDS 5-0; Johnsosn & Johnsosn with atraumatic JRB-1 needle), double duct to mucosa adaptation. Special attention was given to accomplish a duct to mucosa adaptation between duct epithelium and jejunal mucosa as demonstrated in the scheme. A ductal stent or drainage has not been used. The anterior ductal sutures on both ducts, which have been placed previously as first step of the anastomosis, were integrated in order, and each suture was clipped with a mosquito clamp.