Introduction : In this case of laparoscopic pancreaticoduodenectomy, we performed single stitch pancreatic duct suture with drainage tube for pancreaticojejunostomy

Methods : A suitable pancreatic drainage tube (PDT) was prepared to perform PJ. The duct of Wirsung was then detected and one side of PDT was inserted. The PDT is as big as pancreatic duct and make sure there was no space between PDT and pancreatic duct after PDT was inserted. A single stitch was performed to secure the PDT to duct of Wirsung. The stitch was from 12 o'clock to 6 o'clock of pancreatic duct with about 5 mm of pancreatic parenchyma and pancreatic duct included and penetrated the PDT. 4-0 PDS-II (Ethicon) with 17 mm 1/2c needle was recommended for this procedure. Then, interrupted stitches pierced through the full thickness of pancreas and seromuscular layer of jejunum was placed to suture pancreas and jejunum . Two transpancreatic stitches were placed on either side of pancreatic duct, including at least 10mm of pancreas. After finishing the two stitches on the cephalad side of pancreatic duct. A small enterotomy was performed by cautery and a purse suture was performed. The PDT was inserted and carefully secured to the jejunum. The length of PDT inserted into jejunum was about 12 cm. 
At caudal side of pancreatic duct, another two transpancreatic stitches were performed in the same manner as before.


Results : This patient recovered smoothly without any complications.

Conclusions : An encourage results was detected of single stitch pancreatic duct suture with drainage tube for pancreaticojejunostomy（SSPDSPJ）in laparoscopic pancreaticoduodenecomy.