ArticleAnnals of hepato-biliary-pancreatic surgery2017
An intuitive method of duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy: use of one-step circumferential interrupted sutures.
Article in Annals of hepato-biliary-pancreatic surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Blumgart anastomosis reduces the incidence of pancreatic fistula after pancreaticoduodenectomy: a systematic review and meta-analysis.Scientific reports · 2020Pooled it
- Robotic pancreaticoduodenectomy with modified Blumgart anastomosis with self-locking barbed wires: technical aspects and initial results.Surgical endoscopy · 2026Article
- Chen's penetrating-suture technique for pancreaticojejunostomy following pancreaticoduodenectomy.BMC surgery · 2023Article
- Contemporary Surgical, Oncological, and Survival Outcomes of Pancreaticoduodenectomy for Periampullary Tumours: a 5-Year Experience from Tertiary Cancer Center.Indian journal of surgical oncology · 2021Article
- Pancreaticojejunostomy-a review of modern techniques.Langenbeck's archives of surgery · 2020Review
- MODIFIED HEIDELBERG TECHNIQUE FOR PANCREATIC ANASTOMOSIS.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgeryArticle
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Pancreaticoenteric anastomosis is the origin of postoperative pancreatic fistula (POPF). Although a variety of methods have been proposed to decrease the POPF rate, randomized controlled trials performed so far have failed to demonstrate superiority of any particular method to the others. Cattell-Warren duct-to-mucosa pancreaticojejunostomy (PJ) is a widely practiced procedure. Their method is challenging, especially when the pancreatic duct is small. We assumed that the difficulty resides in the pancreatic duct becoming difficult to access when the posterior row is tied before suturing the anterior row. We have modified the duct-to-mucosa PJ so that the entire circumference of the inner layer can be sutured and tied in one-step by anchoring and retracting the anterior row. The jejunal roux-limb and pancreatic stump are positioned spatially apart, allowing enough space for free needle work. During a 13-year period, 151 patients underwent pancreaticoduodenectomy with this method, and the cumulative POPF and mortality rates were 37.1% and 4.6%, respectively. These rates were stable throughout the study period, implicating a relative independence from surgeons' experience. We believe that our method is intuitive, easy to grasp, and can be readily adopted even by surgeons not accustomed to pancreaticoduodenectomy.
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