"True" duct-to-mucosa pancreaticojejunostomy, with secure eversion of the enteric mucosa, in Whipple operation.

Background: Postoperative pancreatic fistula (POPF) due to anastomotic leak is often associated with significant morbidity and mortality. The aim of this study was to present an improved anastomotic technique for Whipple operation, which we call "true" duct-to-mucosa anastomosis (DMA)-pancreaticojejunostomy.

Methods: A novel enteric mucosal eversion at the point of the jejunostomy is constructed prior to the anastomosis with the pancreatic duct in order to enhance sealing.