Legacy of innovation: multicenter validation of Huscher's pancreaticojejunostomy technique-a retrospective observational study.

In 2022, Huscher et al. introduced a novel pancreaticojejunostomy (PJ) technique using an intraductal coronary artery stent as a structural fulcrum to enhance anastomotic stability in high-risk patients. Despite encouraging early results, the technique remained confined to a single center without external validation. The present study addresses this gap by evaluating its multicenter feasibility and reproducibility. This retrospective observational study included all consecutive patients undergoing PJ with intraductal stenting according to Huscher’s technique between 2022 and 2024 across three institutions. Only newly treated patients were included. Seventy-three patients underwent the open approach using a coronary artery stent, and seven underwent robotic PJ using a self-expanding metallic stent. Outcomes were analyzed descriptively and compared for contextual consistency with the original 2022 pilot series. Among 80 consecutive patients, 82.5% were classified as high risk for postoperative pancreatic fistula (POPF), and the remaining 17.5% as intermediate risk, according to a-FRS criteria. Clinically relevant POPF occurred in 5% of cases (4/80), with no mortality and only one late stent displacement. Stent positioning was systematically verified by CT on postoperative days 5 and 30. When compared with the original pilot series, outcomes were consistent, suggesting cross-institutional reproducibility. Robotic adaptation proved feasible, although limited by small sample size. This is the first multicenter experience validating Huscher’s intraductal-stent-based PJ technique. The open approach demonstrated consistent results across independent surgeons and centers, while the robotic application should be considered a feasibility finding. These results support further investigation through larger prospective studies.