STEP 7Division of the pancreas

The neck of the pancreas is divided over the superior mesenteric-portal vein using electrocautery; a large clamp behind the neck of the pancreas protects the vein.

If a neoplasm is suspected, a margin of at least 1 cm to the left of any mass must be maintained and checked with frozen section of the transected margin.

Marginal arteries supplying the pancreas that bleed after the parenchyma is divided are controlled with suture ligatures.

Once the cut edge of the pancreas is hemostatic, the pancreatic duct orifice is identified and ligated with 3-0 polypropylene.

The cut edge of the pancreas is closed with a continuous running suture of 3-0 polypropylene.

Other methods to transed it and "close" the cut edge of the pancreas include using a linear stapler or techniques of tissue welding. A soft, closed-suction drain is placed adjacent to the cut edge of the pancreas and brought out through the left lateral abdominal wall.

The abdominal wall is closed in layers.

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