The orientation of the jejunum to the first two anastomoses is shown. The order is designed to bathe the gastrojejunsotomy with pancreatic juice and bile and decrease the chance of marginal ulcer.
A hand-sewn two layer gastrojejunostomy was created with a 3-0 absorbable continuous inner layer and a 3-0 interrupted silk outer layer. On opening the jejunum there was bile present indicating a patent biliary anastomosis.
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