Background : Laparoscopic pancreaticoduodenectomy (LPD) is feasible option in selected patients. However, it is technically challenging and physically demanding procedure. Pancreaticojejunostomy (PJ) is essential part of LPD that difficult and time-consuming. We will introduce simple and feasible technique of duct-to-mucosa PJ.

Methods : In our institution, 3-4 stitches were performed in posterior wall , 4-5 stitches in anterior wall in duct-to-mucosa technique PJ. All stitches were interrupted and we used plastic internal stent in routine manner. Each stitch consist of following ; peripancreatic fat tissue-pancreatic duct- jejunum mucosa-small bowel serosa. Stitches of peripancreatic fat tissue and small bowel serosa were guide sutures of duct-to-mucosa technique. Stent insertion was done after posterior wall anastomosis and then anterior wall anastomosis was completed.

Results : Operation time was shorter than previous conventional duct-to-mucosa technique. When operator tied each stitch, troublesome problem due to multiple stitches was decreased.

Conclusions : PJ is difficult and time-consuming procedure that demanding learning curve. Simplified method using guide sutures is helpful to overcome the duct-to-mucosa PJ technique.