Abstract: The history and recent advances of pancreaticojejunostomy        YAN Wei-kang，LIU Ying-bin. Department of Biliary-Pancreatic Surgery，Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine；Shanghai Cancer Institute，State Key Laboratory of Oncogenes and Related Genes；Shanghai Key Laboratory of Biliary Tract Disease；Shanghai Research Center of Biliary Tract Disease，Shanghai 200127，China 
Corresponding author：LIU Ying-bin，E-mail：laoniulyb@163.com
Abstract    Originated from pancreaticoduodenostomy，pancreaticojejunostomy can be subdivided into three parts including end-to-end, end-to-side and duct-to-mucosa after more than a hundred years of development. As one of the most influential factors of the fatal pancreatic fistula，the method of pancreaticojejunostomy has been studied and improved in recent years. The newly invented anastomosis methods，such as purse-string suturing technique，binding pancreaticojejunostomy，"U"-suture technique，shark mouth pancreaticojejunostomy，Blumgart anastomosis, and single-stitch pancreatic duct suture，are worth introducing here because of their inspiration，innovation and practicality.At present, there is still insufficient evidence to indicate which anastomosis technique has a clear advantage in preventing pancreatic fistula. Regardless of open surgery or laparoscopic surgery, the current consensus recommends that the operator should choose a more skilled technique based on his own experience, so as to improve the quality of the anastomosis. The mechanism of pancreatic fistula needs to be further studied to guide the reconstruction of pancreatic stump and avoid the occurrence of pancreatic fistula.

Key words: pancreatic neoplasms, pancreaticoduodenectomy, pancreatojejunostomy

摘要： 胰肠吻合从胰管十二指肠吻合的雏形，发展至胰肠端端吻合、胰管空肠端侧吻合和胰管空肠黏膜吻合三大类的成熟阶段已有百余年历史。作为胰瘘这一严重并发症的关键影响因素之一，胰肠吻合方式在近年来也多有研究与改良，如荷包式吻合、捆绑式吻合、“U”形贯穿缝合、鲨嘴式吻合、Blumgart法、一针法等，各具启发性、创新性、实用性。目前，仍没有足够充分的证据表明哪一种吻合技术在预防胰瘘发生方面有明确的优势。无论是传统的开放手术，还是腹腔镜手术，现有的共识均推荐术者根据自身经验选择熟练程度较高的术式，以提高吻合质量为主。外科医师仍需更深入地研究胰瘘的发生机制，以更明确指导胰腺残端的重建，尽可能避免发生胰瘘。

关键词: 胰腺肿瘤, 胰十二指肠切除术, 胰腺空肠吻合