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Related Experiment Video

Updated: Mar 26, 2026

Technical Detail for Robot Assisted Pancreaticoduodenectomy
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Pancreatojejunostomy with modified purse-string suture technique.

Dezső Kelemen1, Róbert Papp2, Bálint Kaszás2

  • 1Department of Surgery, Clinical Centre, University of Pécs, Ifjúság útja 13., 7624, Pécs, Hungary. kelemende@gmail.com.

Langenbeck'S Archives of Surgery
|February 10, 2016
PubMed
Summary

This study presents a modified purse-string suture technique for pancreatic anastomosis, reducing pancreatic fistula rates in patients undergoing pancreatic resection. The improved method enhances surgical safety for complex pancreatic surgeries.

Keywords:
Mattress suturePancreatic fistulaPancreatojejunostomyPurse-string suture

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Area of Science:

  • Gastroenterology and Surgical Oncology
  • Minimally Invasive Surgical Techniques

Background:

  • Pancreatic fistula is a significant complication after pancreatic resection, particularly with soft pancreatic tissue.
  • Current techniques for pancreatodigestive anastomosis require refinement to improve patient outcomes.

Purpose of the Study:

  • To introduce a modified purse-string pancreatodigestive anastomosis technique.
  • To evaluate the safety and efficacy of this modified technique in reducing pancreatic fistula rates.

Main Methods:

  • A modified purse-string suture technique involving one purse-string and two U-shaped mattress sutures was applied in 49 patients.
  • An external stent was used for soft pancreatic parenchyma during pancreatojejunal anastomosis.
  • The study included patients with pancreatic cancer, primarily undergoing pylorus-preserving Whipple procedures.

Main Results:

  • The overall postoperative early morbidity was 35%.
  • Two cases of pancreatic fistula were observed (4.2% grade A, 4% grade B), with no reoperations or mortality.
  • The technique demonstrated a low incidence of severe complications.

Conclusions:

  • The modified purse-string suture technique offers a safer approach for pancreatodigestive anastomosis.
  • This modification contributes to improved outcomes in pancreatic resections, especially in challenging cases.