**3. Patients and perioperative data**

#### **3.1. PD with Shuriken‐shaped umbilicoplasty**

We experienced 10 cases of PD by real‐time moving window's method. Mean age was 72.6 ± 4.2 years old. Operative procedures were mentioned as described above. The pancreaticojejunos‐ tomy was done by our original stent slide guiding method. The patient's profile is demon‐ strated in **Figure 5**. Average of operative times was 528 ± 63 min. Average of operative blood was 795 ± 405 ml. Average of hospital stay was 33 ± 21 (17‐90). Two patients suffered from liver abscess, and their hospital stay was prolonged by 42 and 90 postoperative days, respectively. There were no cases that had bile leakage. Pancreatic leakage was only one case of grade A by ISGPF classification (**Table 1**).

#### **3.2. Pancreaticojejunostomy by punctured stent slide guiding method**

Ten cases were operated using the Shuriken‐shaped umbilicoplasty and one case by the usual open surgery. We divided the PD with PJ reconstruction into three groups from 2004 to 2015 in our center. There were 114 cases of PD with PJ reconstruction operated by the previous HPB surgeons in Group A from 2004 to 2013. There were 24 cases operated by present HPB surgeons from 2014 to 2015. Eleven cases in Group C were operated by the first author using PSSGM from 2014 to 2015. The 13 cases of Group B were operated by other surgeons without PSSGM. The PLs were compared among three groups according to the ISGPF criteria.
