ArticleSurgical endoscopy2023
A duct-to-mucosa pancreaticojejunostomy for small main pancreatic duct and soft pancreas in minimally invasive pancreaticoduodenectomy.
Article in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 11 citations in OpenAlex.
- Impact of age on safety of pancreaticoduodenectomy: a nationwide cohort study stratified by surgical approach and anastomotic technique with optimal age cut-off analysis.Science China. Life sciences · 2026Article
- The surgical outcomes of modified Chen's U-suture technique compared with duct-to-mucosa anastomosis in laparoscopic pancreaticoduodenectomy: a multi-center cohort study.Surgical endoscopy · 2026Article
- Development and frontier trends of pancreaticojejunostomy over the past 26 years: bibliometric and visual analysis.Gland surgery · 2026Article
- Article
- Evolution and precision trends of pancreaticojejunostomy in pancreaticoduodenectomy.Frontiers in oncology · 2026Review
- A modified stent-free Chen's U-suture technique in pediatric pancreaticojejunostomy: safety and efficacy.Frontiers in pediatrics · 2026Article
- Binding and interlocking pancreaticojejunostomyWorld journal of gastrointestinal surgery · 2025Article
- Efficacy of Chen's pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy.BMC surgery · 2025Article
- A modified single-needle continuous suture of duct-to-mucosa pancreaticojejunostomy in pancreaticoduodenectomy.Gland surgery · 2023Article
- Pancreatectomy and Pancreatic Surgery.Life (Basel, Switzerland) · 2023Article
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13 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative pancreatic fistula (POPF) is often associated with significant morbidity and mortality after the Whipple operation. Patient-related factors associated with POPF include soft pancreatic texture and a small main pancreatic duct (MPD). The traditional duct-to-mucosa anastomosis was modified to be easily performed. The aim of the study was to evaluate the simplified pancreaticojejunostomy (PJ) method in the prevention of POPF after minimally invasive pancreaticoduodenectomy (PD).
methodsNinety-eight patients who underwent laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD) with a simplified PJ procedure containing only two duct-to-mucosa sutures and four penetrating-sutures to anastomose the pancreatic parenchyma and jejunal seromuscular layer in our center were retrospectively studied. Demographics and clinical short-term safety were assessed.
resultsAll LPD and RPD procedures were successfully performed. The median time of PJ was 17 min, and the median blood loss was 60 mL, with only one patient requiring transfusion. Four patients (4.1%) suffered from clinically relevant POPF (CR-POPF), including four grade B cases and no grade C cases. For patients with an MPD diameter of 3 mm or less, POPF was noted in two (4%) of the fifty patients, with all cases being grade B. Of the patients with a soft pancreas, only two (4.5%) patients suffered from grade B POPF. One patient (1.0%) experienced a 90-day mortality. Neither the main pancreatic diameter nor pancreatic texture had an impact on postoperative outcomes.
conclusionsOur technique is a simple, safe and efficient alternative to prevent POPF after LPD and RPD. This method is suitable for almost all pancreatic conditions, including cases with a small main pancreatic duct and soft pancreas, and has the potential to become the preferred procedure in low-volume pancreatic surgery centers. Our modified duct-to-mucosa PJ, which contains only two duct-to-mucosa sutures and four penetrating-sutures to anastomose the pancreatic parenchyma and jejunal seromuscular layer, is ideal for small MPD and soft pancreas when performing minimally invasive PD and has a low rate of POPF. PJ pancreaticojejunostomy, MPD main pancreatic diameter, PD pancreaticoduodenectomy, POPF postoperative pancreatic fistula.
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