Telescopic technique associated with mucosectomy: a simple and safe anastomosis in pancreaticoduodenectomy

Pancreatic fistula remains a common problem and a main cause of morbidity and mortality after pancreaticoduodenectomy (PD). We have developed a safe and simple method of pancreaticojejunostomy in 33 patients, in whom approximately 3 cm of jejunal mucosa was cut to improve the adhesion between the loop and pancreatic parenchyma after end-to-end invagination. Furthermore, we have performed a purse-string procedure on 21 patients to secure the jejunum to the intussuscepted pancreatic stump instead of continuous running fashion with double needles of 5-0 monofilament synthetic absorbable sutures. This procedure was proved to be much more expeditious, and only 2 of 33 patients had pancreatic leakages. Therefore, the telescopic technique associated with mucosectomy is an acceptable and safe surgery for pancreaticojejunal anastomosis.