From the Hypothesis of Pancreatic Fistula to the Clinical Use of Binding Pancreaticojejunostomy

Over the past 100 years, Many techniques have been proposed for the reconstruction of the pancreaticodigestive anastomosis to prevent the development of a postoperative pancreatic fistula, but which is the best approach is still highly debated. The problem with the anastomosis techniques is that there is always a potential gap between the adjacent stitches, which could become the breaking point of pacreaticoenteric anastomosis leakage. Furthermore, there are needle holes on the surface of the anastomotic site after needle penetrating the sero-muscular layer. In case the needle penetrates a small branch of pancreatic duct, pancreatic juice could leak from the needle hole. Such a hypothesis forms the basis of the binding pancreaticojejunostomy. Binding pancreaticojejunostomy is a safe and effective technique that avoids the primary complication of pancreatic anastomosis leakage.