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Fig. 5 | BMC Surgery

Fig. 5

From: A structured program for teaching pancreatojejunostomy to surgical residents and fellows outside the operating room: a pilot study

Fig. 5

Steps of simulation training of pancreatojejunostomy. (1) The anastomotic site was marked, and a pancreatic drainage tube inserted through the hole in the small bowel for the anastomosis with the pancreatic duct. (2) Five U-shaped sutures on the posterior side of the small bowel and the pancreatic parenchyma were placed. (3) Duct-to-mucosa anastomosis at eighth point. First, three sutures were placed in the ventral side of the pancreatic duct to open the pancreatic duct. After that, five sutures were placed through pancreatic duct and small bowel on the dorsal side. The surgeons must be careful not to entangle the sutures. (4) After tying the three sutures on posterior side, the drainage tube was inserted into the pancreatic duct. (5) To wrap the stump of the pancreas, sutures were placed on the anterior wall of the small bowel. (6) After ligating the sutures, the pancreatojejunostomy was completed

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