A modified pancreaticojejunostomy anastomotic technique using double U-sutures for laparoscopic pancreaticoduodenectomy

Updates Surg. 2024 Apr 5. doi: 10.1007/s13304-024-01815-5. Online ahead of print.

Abstract

Although recent advances in laparoscopic technology have popularized laparoscopic pancreatoduodenectomy (LPD), laparoscopic pancreaticojejunostomy anastomosis (PJA) still presents a major technical challenge. From February 2021 to January 2023, 42 patients underwent LPD with modified double U-suture PJA. Data on the demographic characteristics and clinical results of these patients were investigated. The median operation time was 316 min (249-596 min). The median PJA time was 32 min (25-40 min). The median intraoperative blood loss was 150 mL (50-500 mL). The median postoperative stay was 12 days (7-30 days). Complications occurred in 10 (23.8%) patients, including two cases (4.8%) of delayed gastric emptying and nine cases (21.4%) of postoperative pancreatic fistula (POPF). One patient presented delayed gastric emptying and POPF. Eight patients (19.0%) experienced biochemical leakage, and one patient (2.4%) had grade B POPF. Laparoscopic double U-suture PJA is a feasible and safe technique for performing LPD.

Keywords: Laparoscopic pancreaticoduodenectomy; Pancreaticojejunostomy anastomosis; Periampullary carcinoma; Postoperative pancreatic fistula; U-sutures.