Pancreaticojejunostomy "dunk" technique
Two-layer bowel anastomosis-style PJ reconstruction with stent
00:09 SURGICAL TECHNIQUE
01:38 SEROSA POSTERIOR WALL
04:00 MUCOSA POSTERIOR WALL
06:18 MUCOSA ANTERIOR WALL
07:06 SEROSA ANTERIOR WALL
- The classic bowel anastomosis-style pancreaticojejunostomy, is also referred to as the "dunk" PJ.
- To embed the pancreas cut surface into the small bowel, interrupted sutures are first placed in the pancreas, posterior to the cut surface, and then placed on the anti-mesenteric side of the bowel, perpendicular to the long axis.
- An inner layer of sutures secure the pancreas cut surface to the small bowel mucosa, while a second outer layer folds bowel serosa over the pancreas cut edge, preventing pancreas capsule tearing and relieving tension on the inner mucosal anastomosis.
- This technique is traditionally done without a stent, or any stitches placed in the duct, however in this case a stent was deemed necessary.
CTs scans (venous phase)