<p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> <p>Breakdown of the pancreaticoenterostomy is responsible for a number of complications and for the
high mortality associated with pancreaticoduodenectomy. Although in recent years the postoperative
mortality has dropped to less than 10% and in some to less than 5%, pancreatic fistula remains
the most common and troublesome complication.</p> <p>Various procedures, such as duct ligation or occlusion, resection of the pancreatic stump or
pancreaticogastrostomy, have been proposed to treat the pancreatic stump when it is considered
unsuitable for jejunal anastomosis. A little trick permitted us to perform 41 consecutive end to end
pancreaticojejunostomies, irrespective of the conditions of the pancreatic stump, with only 3
pancreatic fistulas (7%) and without fistula related deaths.</p>
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HPB Surg. 1996; 9(3):141-143