Fig. 1

The placement of the inter-anastomosis drainage (IAD) tube. After completing the duct-to-mucosa anastomosis, the IAD tube was placed at the interspace between the jejunal wall and pancreatic parenchyma through the end of the jejunum (a). A 10 Fr silicone tube (BLAKE Silicone Drains-Hubless, Ethicon) was arranged in an “I” shape and was inserted into the inter-anastomosis space. The external drainage tube of the MPD stent was placed and fixed, and Blumgart mattress sutures (3-0 PDS-II, Ethicon) were ligated by wrapping the IAD tube inside (b). The IAD tube was completely enveloped by the jejunal wall and pancreatic parenchyma (c). Reinforcing 4-0 PDS-II sutures were occasionally added to both edges in order to ensure a water-tight seal. At the end of the surgery, the IAD suction tube was connected to a low-pressure continuous-suction device