To investigate the clinical value of pancreatico-jejunal invaginated anastomosis by removing seromuscular layer of the jejunum.

After pancreaticoduodenectomy, the pancreatic stump was freed from the surrounding vessels and structures for a length of 2.5-3.0 cm in 174 patients from August 1985 to October 2008. A jejunal loop was prepared for the pancreatico-jejunal anastomosis by removing the seromuscular layer of the first 2.0-2.5 cm of the bowel where it would be anastomosed. Invagination procedure was then performed for an end to end anastomosis. Pancreatic stump was finally anchored through the wall of the jejunum superiorly and inferiorly, approximately 1.0-1.5 cm from the seromuscular border of the jejunum. Fibrin tissue adhesive was spraied around stomal in pancreatojejunostomy. The status of patient’s rehabilitation and operative complications were investigated after digestive tract reconstruction.

Eight cases of pancreatic leakage(4.6%) were observed. All patients were cured by administrated with sandostatin or stilamin. Postoperative serious complications such as abdominal infection or heavy bleeding were not observed.

Pancreatico-jejunal invaginated anastomosis by removing seromuscular layer of the jejunum in alimentary tract reconstruct after pancreaticoduodenectomy may promote the recovery of patients by preventing potential anastomotic leakage, irrespective of the conditions of the pancreatic stump.