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Classic Kausch–Whipple operation. (a) The schematic shows the lines of resection: antrum, head of pancreas and duodenum. (b) The proximal end of the jejunum is brought to the liver bed and a hepaticojejunostomy is performed. The jejunal limb is used to create a gastrojejunosotmy. Notice that the afferent limb can be quite short, and thus accessible with a colonoscope or even a duodenoscope. However, the success rate of using ‘shorter’ scopes is about 50%.
