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Among the complications following Pancreato-Duodenectomy (PD), Post-Operative Pancreatic Fistula (POPF) is the most common complication. Different techniques and adjuncts for safer anastomosis were suggested, mainly for small caliber main pancreatic duct, none can completely eliminate the risk of leakage. Recently, we have introduced a new technique, using a Seldinger approach for small caliber main pancreatic duct. Since then, we have used this maneuver several times with encouraging results.

Challenging Pancreato-enteric Anastomosis during Whipple Procedure: How to Overcome this Problem?