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Updated: Apr 15, 2026
Laparoscopic Pancreatoduodenectomy With Modified Blumgart Pancreaticojejunostomy
Published on: June 17, 2018
Does modified Blumgart pancreatojejunostomy compared with original Blumgart pancreatojejunostomy decrease the rate of
Fernando Revoredo Rego1, Gustavo Reaño Paredes1, Fritz Kometter Barrios1
1Department of Surgery, Pancreas Spleen and Retroperitoneum Surgery Service, Guillermo Almenara Irigoyen National Hospital, Lima, Perú.
Backgrounds/Aims:
The most common cause of morbidity following pancreatoduodenectomy (PD) is the clinically relevant postoperative pancreatic fistula (CR-POPF). There is currently no universally accepted technique for pancreato-enteric anastomosis. This study aims to compare the Blumgart technique (B-PJ) with the modified Blumgart technique (mB-PJ).
Methods:
This is a retrospective study involving patients who underwent PD between January 2011 and December 2021. The primary endpoint was to compare the incidence of CR-POPF. Secondary endpoints included major morbidity, length of postoperative stay, rates of reoperation, hospital readmission, postoperative mortality, and predictors of CR-POPF. Propensity score matching (PSM) was employed to minimize potential selection bias.
Results:
The study included 292 patients. After PSM, the incidence of CR-POPF was not significantly different between B-PJ and mB-PJ (18.9% vs. 15.8%, p = 0.566). No statistical differences were observed in the secondary endpoints. Independent predictors of CR-POPF included preoperative cholangitis (odds ratio [OR]: 4.906, 95% confidence interval [CI]: 1.440-16.713, p = 0.011), soft pancreas (OR: 4.259, 95% CI: 1.043-17.376, p = 0.043), and main pancreatic duct size ≤ 3 mm (OR: 5.229, 95% CI: 1.865-14.656, p = 0.002).
Conclusions:
This study did not demonstrate that mB-PJ is superior to B-PJ in reducing the incidence of CR-POPF. Factors such as soft pancreas, main pancreatic duct size, and preoperative cholangitis are identified as independent risk factors for CR-POPF.
