The structure of pancreaticojejunal anastomotic chain A. (a) A hollow semicylinder ring on the same side. (b) A needle-shaped protuberance on the inner side of the hexagonal column. (c) A hollow rectangular cuboid. (d) An -shaped protuberance opposite the position of the needle-shaped protuberance.
The structure of pancreaticojejunal anastomotic chain B. Chain B is the same as chain A, with the exception that it does not have semicylinder rings.
Operation procedures. (a) The head of the pancreas is trimmed, and the pancreatic stump is cleaned. The length of the free pancreatic stump is approximately 30.0 mm. (b) The jejunum is prepared for anastomosis to the pancreatic stump. (c) After trimming, chain A is placed on the pancreatic stump approximately 20.0 mm away from the pancreatic stump with suitable tightness. (d) and (e) The free jejunal end is fixed to the hollow semicylinder ring of chain A by a through-and-through continuous suture using a 3–0 suture. (f) Chain B is first trimmed and then passed through the pancreatico-duodenal junction approximately 10 mm from chain A, avoiding the jejunal mesenteric vessels to further fix the anastomosis position between the pancreatic stump and the jejunal end with appropriate tightness.
Pancreaticojejunostomy completed using anastomotic chains in pigs. (a) The jejunum is attached to the pancreatic body by pancreaticojejunal anastomosis chain A. (b) and (c) The distal jejunum is fixed to the semicylinder rings of chain A with a 3–0 suture. (d) Chain B is clipped 10 mm from the distal end of chain A.
Pathological examination of the anastomotic tissues. Pathological examination showed that the anastomotic surface was completely healed, that most capillaries had disappeared at the anastomotic location, and that there was a decrease in the number of fibroblasts and an increase in the number of collagen fibers. The pancreatic cutting surface was primarily epithelialized and showed no evidence of ischemic necrosis. (a) indicates the pancreatic side, and (b) indicates the jejunal side of the pancreaticojejunal anastomosis on the fourth postoperative week.
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