Fig. 2

Limited resection of the annular segment and jejunal patch. a The pancreatic tissue encircling the descending part of the duodenum was detected intraoperatively. The cystic mass was also found in the annular segment. b, c The anterior annular segment was easily separated from the second portion of the duodenum. After resection of the annular segment, congestion of the separated surface of the duodenum was revealed. The schema of the appearance of the operative field after limited resection of the annular pancreas is demonstrated. d, e The second portion of the duodenum and the pancreatic stump were covered by the jejunum to prevent duodenal leakage and pancreatic fistula formation. The schema of the appearance of the operative field after this procedure is demonstrated. D duodenum, P pancreas, J jejunum