The open end of the jejunal arm is anastomosed over the opened pancreatic duct (Figure 9). The jejunum is anchored to the capsule of the tail of the fibrotic pancreas just beyond the end of the incision into the duct, and the full thickness of the jejunal wall is anchored to the cut margins of the capsule of the pancreas throughout the full length of the opened pancreatic duct. The open (fishmouth) end of the jejunum may need to be tailored from time to time, as outlined by the dotted lines (Figure 9), to ensure a sealed anastomosis around the duct. Again, only the capsule is included in these sutures, and the fibrotic wall of the pancreas is left free to promote drainage of the fine ducts, many of which are filled with small calculi. The anterior layer is also made with interrupted sutures, and the free end of the jejunum is anchored to the capsule with three or four additional sutures toward the tail of the pancreas (Figure 10). When the pancreas is shortened and thickened, a splenectomy may be necessary to adequately mobilize the pancreas and facilitate this anastomosis.