Fig. 1

Schematic illustration of the modified invaginated pancreaticojejunostomy approach for pancreaticoduodenectomy. a Search the main pancreatic duct and insert the support catheter. b The posterior wall of the pancreaticojejunostomy was sutured from the lower edge of the pancreas. c The jejunum started from the mesentery margin and was sutured by the inversion of the plasma muscular layer. d The suture of the posterior wall of the anastomosis was performed under direct vision without tightening the sutures. e After the jejunum-side mucosa was embedded, the sutures were tightened together after the posterior wall anastomosis was completed. f Pancreas suture started from the pancreas. g The jejunum seromuscular layer suture and each needle must be tightened. h Knot to the lower edge of the pancreas and the end of the line. i Sleeve around the pancreas about 3 cm