An end-to-end pancreaticojejunostomy using a mechanical purse-string device.

Pancreatic-jejunal anastomosis leaks are a major cause of morbidity and mortality after pancreaticoduodenectomy. We have used a mechanical purse-string device to secure the jejunum to the intussuscepted pancreatic stump in 17 patients. A major leak developed in 1 patient and minor leaks developed in 2 patients, all of which were managed nonoperatively. This technique is expeditious and safe.