The main risk in cephalic duodeno-pancreatectomy for cancer is disruption of the anastomosis between the jejunum and the fragile pancreatic isthmus, as it may result in pancreato-biliary fistula with highly damaging local and regional repercussions. This risk can be reduced by inserting a 60 cm jejunal loop between the pancreatic and biliary anastomoses. The loop prevents biliary reflux and turns any possible disruption into a pure pancreatic fistula, better tolerated. The authors have used this techniques in 20 consecutive patients. The mortality rate was nil. In each of the four-fistulae that occurred, discharge of pancreatic juice ceased within 3 weeks.