End-to-End Invaginated Pancreaticojejunostomy with Three Overlapping U-Sutures––A Safe and Simple Method of Pancreaticoenteric Anastomosis

Li, Tao; Luo, Li-Xi; Zhang, Chun; Wang, Gang-Pu; Chen, Zeting; Jiang, Zhichao; Wang, Xiangyu; Zhi, Xuting

doi:10.3109/08941939.2014.982313

Cited by 10 publications

(4 citation statements)

References 22 publications

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“…[ 83 ] Several recent studies and meta-analyses have reported POPF results from various variations of surgical anastomotic techniques. [ 43 , 47 , 48 , 50 , 65 , 84 , 85 ]. Six meta-analyses [ 43 , 45–48 , 50 ] have investigated the effect of the two most commonly performed anastomotic techniques for creating continuity between the pancreas remnant and the gastrointestinal tract – pancreaticogastrostomy and pancreaticojejunostomy – and their effect on fistula rates, and found significantly different rates of POPF in all six meta-analyses.…”

Section: Resultsmentioning

confidence: 99%

Risk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive review

Søreide

Labori

2016

Scandinavian Journal of Gastroenterology

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Background: Pancreas surgery has developed into a fairly safe procedure in terms of mortality, but is still hampered by considerable morbidity. Among the most frequent and dreaded complications are the development of a post-operative pancreatic fistula (POPF). The prediction and prevention of POPF remains an area of debate with several questions yet to be firmly addressed with solid answers. Methods: A systematic review of systematic reviews/meta-analyses and randomized trials in the English literature (PubMed/MEDLINE, Cochrane library, EMBASE) covering January 2005 to December 2015 on risk factors and preventive strategies for POPF. Results: A total of 49 systematic reviews and meta-analyses over the past decade discussed patient, surgeon, pancreatic disease and intraoperative related factors of POPF. Non-modifiable factors (age, BMI, comorbidity) and pathology (histotype, gland texture, duct size) that indicates surgery are associated with POPF risk. Consideration of anastomotic technique and use of somatostatin-analogs may slightly modify the risk of fistula. Sealant products appear to have no effect. Perioperative bleeding and transfusion enhance risk, but is modifiable by focus on technique and training. Drains may not prevent fistulae, but may help in early detection. Early drain-amylase may aid in detection. Predictive scores lack uniform validation, but may have a role in patient information if reliable pre-operative risk factors can be obtained. Conclusions: Development of POPF occurs through several demonstrated risk factors. Anastomotic technique and use of somatostatin-analogs may slightly decrease risk. Drains may aid in early detection of leaks, but do not prevent POPF.

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Section: Resultsmentioning

confidence: 99%

Risk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive review

Søreide

Labori

2016

Scandinavian Journal of Gastroenterology

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“…For this reason, surgeons have always directed their efforts at reducing the rate of pancreatic fistula through the introduction of new and effective methods of construction of the pancreatic anastomosis [14][15][16][17]. Various techniques have been described for joining the pancreatic stump either with the jejunum or with the stomach, with or without internal or external drainage of the pancreatic duct [18].…”

Section: Introductionmentioning

confidence: 99%

Pancreaticojejunostomy Versus Pancreaticogastrostomy After Pancreaticoduodenectomy: An Up-to-date Meta-Analysis

Guerrini

Soliani

D’Amico

et al. 2015

Journal of Investigative Surgery

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“…[17][18][19] Kim et al [20] then modified Peng's technique, and after placing the stump 3 cm deep into the intestine, they used only two transpancreatic U-sutures securing the upper and lower border of the jejunum. Li et al [21] further published a new technique of pancreaticojejunal end-to-end anastomosis with two to four single interrupted U-sutures (Chen's U-suture), performed with double-armed sutures (Fig. 2).…”

Section: Modifications Of the Standard Invagination Techniquementioning

confidence: 99%

Secure reconstruction after pancreaticoduodenectomy: Review and improved our continuous duct-to-mucosa anastomosis

Hwang¹,

Kao²,

Hsu³

et al. 2022

Formos J Surg

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Pancreatic anastomotic leakage is the most common major complication after pancreaticoduodenectomy (PD). The incidence of pancreatic anastomotic leak or fistula has declined to less than 20%, and mortality from this complication has decreased to less than 10% in recent years. The ideal surgical procedures to achieve the most secure pancreaticojejunostomy were compared and reviewed. A single-institution and personal experience was retrogradely compared with two periods between 1988 and 2017, which involved 121 patients who were designed to compare the outcome of complications with or without pancreatic stump by four to six sutures before continuous duct-to-mucosa PD. The surgical reconstruction technique was standardized and unique, and the pancreaticojejunal anastomosis was created using the duct-to-mucosa without (group A, n = 62) and with (group B, n = 59) interrupted stump sutures. The rate of grade A pancreatic fistula was 6.9% in group A and 0% in group B (P < 0.05). Postoperative mortality was 0% in group B. No patient underwent reoperative PD due to pancreatic anastomotic leak. The length of stay during admission and after surgery was significant lower in group B, which was due to less complication after surgery. Interrupted suture of pancreatic stump with a continuous duct-to-mucosa end-to-side pancreaticojejunostomy plus external drainage is the best secure method for pancreaticojejunostomy after PD.

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End-to-End Invaginated Pancreaticojejunostomy with Three Overlapping U-Sutures––A Safe and Simple Method of Pancreaticoenteric Anastomosis

Cited by 10 publications

References 22 publications

Risk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive review

Risk factors and preventive strategies for post-operative pancreatic fistula after pancreatic surgery: a comprehensive review

Pancreaticojejunostomy Versus Pancreaticogastrostomy After Pancreaticoduodenectomy: An Up-to-date Meta-Analysis

Secure reconstruction after pancreaticoduodenectomy: Review and improved our continuous duct-to-mucosa anastomosis

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