Order of anastomosis in Whipple's procedure:
Tumor position Procedure Head (malignant) Pylorus preserving Whipple's procedure Head (benign) Enucleation Body & Tail Distal pancreatectomy. Whipple's procedure: Pancreaticojejunostomy, Hepaticojejunostomy Gastrojejunostomy Pylorus preserving Whipple's procedure: Pancreaticojejunostomy, Hepaticojejunostomy, Gastrojejunostomy, Duodenojejunostomy. Maxium risk of leak occurs from Pancreaticojejunostomy > Gastrojejunostomy > Hepaticojejunostomy.
Pancreaticojejunostomy, gastrojejunostomy, hepaticojejunostomy
Hepaticojejunostomy, pancreaticojejunostomy, gastrojejunostomy
Gastrojejunostomy, pancreaticojejunostomy, hepaticojejunostomy
Pancreaticojejunostomy, hepaticojejunostomy, gastrojejunostomy
Pancreas