Single-layer continuous duct-to-mucosa pancreaticojejunostomy: "how we do it"

Area of Science:

• General Surgery
• Surgical Oncology
• Gastroenterology

Background:

• Pancreatic anastomosis is a complex surgical procedure.
• Postoperative pancreatic fistula (POPF) remains a significant complication.
• No single technique is universally superior for preventing POPF.

Purpose of the Study:

• To evaluate the feasibility of a simplified single-layer continuous duct-to-mucosa pancreaticojejunostomy technique.
• To assess the efficacy of this new method in preventing POPF.

Main Methods:

• A prospective, single-center, single-arm trial was conducted.
• The study included the first 20 patients undergoing Whipple's procedure with the new technique.
• Data on patient characteristics, risk factors, and postoperative outcomes were collected.

Main Results:

• The technique was applied to 20 patients, including 10 high-risk cases.
• A low rate of grade B POPF (10%) and no grade C POPF were observed.
• Overall morbidity was 30%, with no reoperations or 90-day mortality.

Conclusions:

• Single-layer continuous duct-to-mucosa pancreaticojejunostomy is a feasible and simplified approach.
• Further research is needed to determine its indications and efficacy in POPF prevention.