Duct to mucosa isolated Roux loop pancreaticojejunostomy as an improved anastomosis after resection of the pancreas.

An alternative to the widely used end to end invaginating technique for pancreaticojejunal anastomosis is described herein. The pancreatic duct is anastomosed by multiple interrupted sutures to an aperture on the side of an isolated Roux loop. The anastomosis is completed with a second layer of serosa to capsule sutures, and transanastomotic stents are avoided unless the duct is small (3 millimeters or less in diameter). Ten anastomoses were performed safely in this way without leakage.