Fig. 2

Steps of modified Blumgart technique in pancreatojejunostomy. Panel a, four to five “U” style stitches are placed superior and inferior the pancreatic duct, which passes through entire layer of the pancreatic stump and seromuscular layer of the jejunum (3–0 suture). Panel b, a separate horizontal interrupted stitch is then placed below the duct (4–0 suture). Panel c, a stent is routinely placed after making a small hole through the jejunal wall, which is fixed by the 4–0 suture. Panel d, four duct-to-mucus vertical interrupted stitches are subsequently placed at approximate 2, 4, 8, 10 o’clock, respectively (5–0 suture). Panel e, all 3–0 sutures are tightened and then pass through seromuscular layer of the anterior jejunum. Panel f, tie all the 3–0 sutures and a stable pancreatojejunostomy is finished