Fig. 2

Intraoperative images of the reconstruction of PJ following modified Blumgart method in LPD. (a): A stent tube with a suitable diameter matching pancreatic duct was inserted into the pancreatic duct. (b): The potential gaps between the stent tube and pancreatic tube cavity were closed by purse suture with 4 − 0 Prolene suture line. (c): A 3 − 0 Prolene suture line with a large needle ran through the whole layer of the pancreas at the site 0.5 ~ 1.0 cm from the edge of the pancreatic stump, then entered the seromuscular layer of the jejunal posterior wall. After protruding out, the needle penetrated through the whole layer of the pancreas again, and the breath of suture was 1.0 ~ 1.5 cm. (d): The first layer suture could be finished only needed for 3 ~ 5 stitches which were overlapped. (e): The other end of the stent tube be inserted into the jejunum lumen through a small incision. (f): The potential gaps between the stent tube and jejunum lumen were closed by purse suture with 4 − 0 Prolene suture line. (g): The ends of the above two purse suture ’lines were tied together to form a fixed sinus between the pancreatic duct and jejunum mucosa. (h): The second layer was made a simple interrupted at 3 or 5 sites in the overlapped way or continuous suture according to the width of the pancreas between the seromuscular layer of the jejunal anterior wall and the anterior layer of the pancreatic stump. (i): The image of modified Blumgart PJ finished