A Modified Technique of End‐to‐End Pancreaticojejunostomy With Transpancreatic Interlocking Mattress Sutures

Wang, Min; Zhu, Feng; Wang, Xin; Tian, Rui; Shi, Changcheng; Shen, Ming; Xu, Meng; Han, Juan; Luo, Nian-nian; Qin, Renyi

doi:10.1002/jso.23319

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…In an interesting study, Wang et al used a modified method to incompletely invaginate the pancreatic stump into the jejunal lumen with transpancreatic interlocking mattress sutures [ 21 ]. In this study only two patients (2.53%) with grade A and B pancreatic fistula were found and the median time to perform the end-to-end pancreaticojejunostomy was 15.3 min (range 9–24 min).…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Two Invagination Techniques for Pancreatojejunostomy after Pancreatoduodenectomy

Kusnierz

Mrowiec

Lampe

2015

Gastroenterology Research and Practice

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Background. The aim of the study was to compare two invagination techniques for pancreatojejunostomy after pancreatoduodenectomy. Methods. For effective prevention of the development of pancreatic leakage, we modified invagination technique that we term the “serous touch.” We analysed the diameter of the main pancreatic duct, the texture of the remnant pancreas, the method of the reconstruction, pancreatic external drainage, anastomotic procedure time, histopathological examination, and postoperative complications. Results. Fifty-two patients underwent pancreatoduodenectomy with pancreatojejunostomy using “serous touch” technique (ST group) and 52 classic pancreatojejunostomy (C group). In the ST group one patient (1.9%) was diagnosed as grade B pancreatic fistula, and no patient experienced fistula grade A or C. In the C group 6 patients (11.5%) were diagnosed as fistula grade A, 1 (1.9%) patient as fistula grade B, and 1 (1.9%) patient as fistula grade C. There was a significant statistical difference in incidents of pancreatic fistula (P < 0.05) and no statistical difference in other postoperative complications or mortality in comparison group. Anastomosis time was statistically shorter in the ST group. Conclusions. “Serous touch” technique appeared to be easy, safe, associated with fewer incidences of pancreatic fistulas, and less time consuming in comparison with classical pancreatojejunostomy.

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Section: Discussionmentioning

confidence: 99%

A Comparison of Two Invagination Techniques for Pancreatojejunostomy after Pancreatoduodenectomy

Kusnierz

Mrowiec

Lampe

2015

Gastroenterology Research and Practice

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“Total arterial devascularization first” technique for resection of pancreatic head cancer during pancreaticoduodenectomy

Peng

Wang

Zhu

et al. 2013

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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Integrated resection of the pancreatic head is the most difficult step in radical pancreaticoduodenectomy (RPD) in patients with the portal vein (PV) and superior mesenteric vein (SMV) invasion or oppression by the tumor. This study introduced a new idea and skill named the "total arterial devascularization first" (TADF) technique and its applications in RPD. Three arterial blood supplies of pancreatic head were obstructed before dissection of veins. The critical steps included exposure of the anterior surface of the abdominal aorta (AA) by completely transecting neural and connective tissue between superior mesenteric artery (SMA) and pancreatic mesounsinate, and transection of the mesounsinate from the origin of SMA to the root of the celiac trunk. From January 2012 through May 2013, a total of 58 patients with PV/SMV invasion or oppression underwent RPD using this technique. The median operative time was 5.1 h (ranging 4.5-8.1 h). The median intraoperative blood loss was 450 mL (ranging 200-900 mL). No intraoperative and postoperative bleeding of pancreatic head region occurred. Among the 58 patients, 21 were subjected to vessel lateral wall angiectomy or angiorrhaphy, and 10 to angiectomy and end-to-end anastomosis. The incidence of postoperative bleeding, postoperative pancreatic fistula and biliary fistula was 5.2%, 6.8%, and 1.7%, respectively. No patients died 3 months after operation. The TADF technique is a new method for intricate RPD and could improve the security of surgery and reduce intraoperative bleeding, which is expected to become standardized surgical approach for RPD.

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Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy

Cao

Tong

et al. 2020

Asian Journal of Surgery

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A Modified Technique of End‐to‐End Pancreaticojejunostomy With Transpancreatic Interlocking Mattress Sutures

Abstract: The end-to-end pancreaticojejunostomy with transpancreatic interlocking mattress sutures is a simple, rapid, safe, and reliable technique with low POPF rate and low delayed massive hemorrhage rate.

Cited by 4 publications

References 27 publications

A Comparison of Two Invagination Techniques for Pancreatojejunostomy after Pancreatoduodenectomy

A Comparison of Two Invagination Techniques for Pancreatojejunostomy after Pancreatoduodenectomy

“Total arterial devascularization first” technique for resection of pancreatic head cancer during pancreaticoduodenectomy

Meta-analysis of modified Blumgart anastomosis and interrupted transpancreatic suture in pancreaticojejunostomy after pancreaticoduodenectomy

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