Chen's penetrating-suture technique for pancreaticojejunostomy following pancreaticoduodenectomy

BMC Surg. 2023 May 29;23(1):146. doi: 10.1186/s12893-023-02054-y.

Abstract

Background: Postoperative pancreatic fistula (POPF) is the most serious complication and the main reason for morbidity and mortality after pancreaticoduodenectomy (PD). Currently, there exists no flawless pancreaticojejunal anastomosis approach. We presents a new approach called Chen's penetrating-suture technique for pancreaticojejunostomy (PPJ), which involves end-to-side pancreaticojejunostomy by suture penetrating the full-thickness of the pancreas and jejunum, and evaluates its safety and efficacy.

Methods: To assess this new approach, between May 2006 and July 2018, 193 consecutive patients who accepted the new Chen's Penetrating-Suture technique after a PD were enrolled in this study. Postoperative morbidity and mortality were evaluated.

Results: All cases recovered well after PD. The median operative time was 256 (range 208-352) min, with a median time of 12 (range 8-25) min for performing pancreaticojejunostomy. Postoperative morbidity was 19.7% (38/193) and mortality was zero. The POPF rate was 4.7% (9/193) for Grade A, 1.0% (2/193) for Grade B, and no Grade C cases and one urinary tract infection.

Conclusion: PPJ is a simple, safe, and reliable technique with ideal postoperative clinical results.

Keywords: Chen’s Penetrating-Suture technique; Pancreaticoduodenectomy; Postoperative pancreatic fistula.

MeSH terms

  • Anastomosis, Surgical / methods
  • Humans
  • Pancreas / surgery
  • Pancreatic Fistula / epidemiology
  • Pancreatic Fistula / etiology
  • Pancreatic Fistula / prevention & control
  • Pancreaticoduodenectomy* / methods
  • Pancreaticojejunostomy* / methods
  • Postoperative Complications / etiology
  • Suture Techniques / adverse effects