Maurer W, Fankhauser G
Helv Chir Acta. 1989 Jun;56(1-2):103-6.
From 1972 to January 1988 42 pancreato-duodenectomies were performed. There was no hospital death. In the last 7 patients the pancreatojejunostomy was done over-and-over in one row. In one of those patients the anastomosis had to be redone later on using an identical technique. The video shows selectioned steps in resection and reconstruction, in detail the preparation of the pancreatic stump as well as the anastomosis itself. In 2 cases there was massive secondary gastrointestinal hemorrhage. The bleeding artery could be localized by selective angiography to the jejunal side of the pancreatic anastomosis in 1 case, to the jejuno-jejunostomy in the other patient. Definitive hemostasis was accomplished by reoperation. The one row over-and-over-anastomosis is done without problems in the situation of a fibrotic pancreas and dilatation of pancreatic duct (3 patients). It is suitable too, when alterations of the pancreas are missing (5 cases).
1972年至1988年1月共施行42例胰十二指肠切除术，无医院死亡病例。在最后7例患者中，胰肠吻合采用连续一层缝合法。其中1例患者后来不得不采用相同技术重新进行吻合。视频展示了切除和重建的选定步骤，详细介绍了胰腺残端的制备以及吻合本身。2例发生大量继发性胃肠道出血。1例经选择性血管造影确定出血动脉位于胰肠吻合口空肠侧，另1例位于空肠-空肠吻合口。通过再次手术实现了确切止血。在胰腺纤维化和胰管扩张的情况下（3例患者），连续一层缝合法进行吻合没有问题。在胰腺无病变时（5例）也适用。
