Novel invagination procedure for pancreaticojejunostomy using double purse string sutures: A technical note

Area of Science:

• Surgical Innovation
• Gastrointestinal Surgery
• Oncology

Background:

• Postoperative pancreatic fistula (POPF) is a major complication following pancreaticoduodenectomy (PD).
• Pancreaticojejunostomy (PJ) technique is a critical factor influencing POPF incidence.
• Existing PJ methods have limitations in completely preventing POPF.

Purpose of the Study:

• To detail the procedural steps of a novel invagination technique for PJ.
• To evaluate the technical aspects and clinical efficacy of this new PJ method.
• To assess the safety and feasibility of the invagination PJ for preventing POPF.

Main Methods:

• Retrospective cohort study of 65 patients undergoing PD with the novel invagination PJ.
• Procedure involves pancreatic stent placement, residual pancreas closure, and double purse-string sutures.
• Data collected on patient demographics, pancreatic characteristics, operative details, and postoperative complications.

Main Results:

• Low incidence of POPF (4.62% Grade B, 0% Grade C) observed.
• Other complications included postoperative hemorrhage (7.69%), delayed gastric emptying (9.23%), and infections (pulmonary 6.15%, abdominal 6.15%).
• Mean operation time was 263.83 minutes with mean blood loss of 318.4 mL.

Conclusions:

• The novel invagination technique for PJ is a straightforward and effective procedure.
• This method demonstrates significant outcomes and is safe for clinical application.
• The technique shows promise in reducing POPF incidence after PD.