An end-to-side suspender pancreaticojejunostomy: A new invagination pancreaticojejunostomy

Li, Bin; Xu, Chang; Qiu, Zhiquan; Liu, Chen; Yi, Bin; Luo, Xiang; Jiang, Xiaoqing

doi:10.1016/j.hbpd.2018.02.003

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…Some 23 665 patients had malignant disease and of these 12 097 had pancreatic ductal adenocarcinoma, 3778 distal cholangiocarcinoma, 3189 ampullary carcinoma and 1456 duodenal carcinoma. Study characteristics are summarized in Table S3 14–126 . Ninety‐one studies were retrospective cohort studies, 28 prospective cohort studies and three randomized controlled trials.…”

Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

Kamarajah

Bundred

Lin

et al. 2020

ANZ Journal of Surgery

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Background Many studies have explored factors relating to post‐operative pancreatic fistula (POPF); however, the original definition (All‐POPF) was revised to include only ‘clinically relevant’ (CR) POPF. This study identified variables associated with the two International Study Group on Pancreatic Surgery definitions to identify which variables are more strongly associated with CR‐POPF. Methods A systematic review identified all studies reporting risk factors for POPF (using both International Study Group on Pancreatic Fistula definitions) following pancreatoduodenectomy. The primary outcome was factors associated with CR‐POPF. Meta‐analyses (random effects models) of pre‐, intra‐ and post‐operative factors associated with POPF in more than two studies were included. Results Among 52 774 patients All‐POPF (n = 69 studies) and CR‐POPF (n = 53 studies) affected 27% (95% confidence interval (CI95%) 23–30) and 19% (CI95% 17–22), respectively. Of the 176 factors, 24 and 17 were associated with All‐ and CR‐POPF, respectively. Absence of pre‐operative pancreatitis, presence of renal disease, no pre‐operative neoadjuvant therapy, use of post‐operative somatostatin analogues, absence of associated venous or arterial resection were associated with CR‐POPF but not All‐POPF. Conclusion In conclusion this study demonstrates wide variation in reported rates of POPF and that several risk factors associated with CR‐POPF are not used within risk prediction models. Data from this study can be used to shape future studies, research and audit across ethnic and geographic boundaries in POPF following pancreatoduodenectomy.

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Section: Resultsmentioning

confidence: 99%

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

Kamarajah

Bundred

Lin

et al. 2020

ANZ Journal of Surgery

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“…So, biliary or pancreatic fistula and abdominal infection maybe early method to predict delayed postoperative arterial hemorrhage, and preventing leaks and infection might be considered an effective way to prevent multisite hemorrhage occurrence. Recently, in our center, a new invagination pancreaticojejunostomy was applied to decrease the pancreatic fistula (22).…”

Section: Discussionmentioning

confidence: 99%

Endovascular therapy choices for different sites of delayed postoperative arterial hemorrhage after hepatobiliary pancreatic surgery: a retrospective study

Huang

et al. 2021

Gland Surg

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“…Therefore, a reliable way to better place the tube into the main pancreatic duct and carefully x this structure is needed (21). Hence many surgical procedures have been used in the management of the pancreatic remnant including pancreaticojejunostomy, pancreaticogastrostomy and other new PJ technology (16,17). Besides, recent studies found that the smear positivity of drainage uid on POD 3 was one of the independent risk factors for POPF (22,23).…”

Section: Discussionmentioning

confidence: 99%

“…Well recognized risk factors related to POPF include gender, diabetes, BMI, pancreaticojejunal anastomosis technique, the diameter of the pancreaticduct and pancreatic texture (9) . As pancreaticojejunostomy(PJ) is the most crucial step, numerous surgical groups have investigated several methods to build a stable PJ for reducing the incidence of POPF (2,5,10), including pancreaticogastrostomy(11), duct-to-mucosa anastomosis(12), pancreatic duct occlusion, the use of biologic adhesive (13-15), Chen's U-stitch approach (16) and end-to-side suspender PJ (17). Here, in our institution, we studied a novel anastomosis technique where we use the half purse-string suture on the basis of two-layer duct-to-mucosa pancreaticojejunostomy technique, which effectively invaginated the pancreas into the jejunum in addition to allowing a duct-to-mucosa anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Two-layer duct-to-mucosa pancreaticojejunostomy with a half purse-string suture: A novel anastomosis technique for soft pancreas

Jiang

Wei

et al. 2020

Preprint

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Background: Pancreaticoduodenectomy (PD) is a routine method in pancreatic surgery. To date, postoperative pancreatic fistula (POPF) remains the most common complication and is also the major cause to death after pancreaticoduodenectomy. In order to reduce the incidence of POPF, we established a new anastomosis technique where we use a half purse-string suture on the basis of two-layer duct-to-mucosa pancreaticojejunostomy (PJ) technique and also assessed the effectiveness and safety of this approach in this study.Methods: To evaluate this new approach, 80 patients who received the new PJ technique were included in this study during 2017–2018. Meanwhile, 195 patients who underwent traditional duct-to-mucosa PJ were collected. We also introduced this new surgical approach in detail and analyzed various risk factors for postoperative complications to verify its safety and advantages.Results: First of all, there were no significant differences in patients' preoperative characteristics. Besides, patients in the new PJ group received a less operative time (175.2±45.8 vs. 161.3±41.0, p=0.022) while no differences were found in blood loss, length of hospital stay and cost. The incidence of POPF in the new PJ group was 19%, which was much lower than those in the traditional PJ group (36%) (p=0.007). More importantly, a much lower incidence of grades B POPF (14% vs. 4%, p=0.026) was found in the new technology group, which would clinically benefit patients a lot. Univariate and multivariate regression analysis also verified that this new PJ procedure was effective to improve postoperative POPF.Conclusions: Results demonstrate that this new technique is easy accomplished, safe and effective compared to traditional approach, which showed satisfactory outcomes especially at resulting in a lower POPF incidence.

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An end-to-side suspender pancreaticojejunostomy: A new invagination pancreaticojejunostomy

Cited by 7 publications

References 31 publications

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

Systematic review and meta‐analysis of factors associated with post‐operative pancreatic fistula following pancreatoduodenectomy

Endovascular therapy choices for different sites of delayed postoperative arterial hemorrhage after hepatobiliary pancreatic surgery: a retrospective study

Two-layer duct-to-mucosa pancreaticojejunostomy with a half purse-string suture: A novel anastomosis technique for soft pancreas

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