Chen's Penetrating-Suture technique simple, safe, and reliable technique for pancreaticojejunostomy.

Following pancreaticoduodenectomy (PD), POPF (Postoperative pancreatic fistula) is the most severe complication. It is also a leading cause of morbidity and mortality.

To date, there is no flawless pancreaticojejunal anastomosis approach.

In this study, researchers from the Affiliated Hospital of Yangzhou University presented a new approach named Chen’s penetrating-suture technique for PPJ. It involves end-to-side PPJ by suture penetrating the full-thickness of the pancreas and jejunum and evaluates both safety and efficacy.

The study results are:

• Following PD, cases recovered well.
• The operative time was 256 min.
• The mean time for performing pancreaticojejunostomy was 12 minutes (median).
• Postoperative morbidity was 19.7%.
• The reported mortality was zero.
• The rate of POPF was 4.7% and 1.0 % for Grade A and Grade B, respectively.
• There were no Grade C cases and one urinary tract infection.

They said, “We found PPJ to be simple, safe and reliable.”

The anastomosis mode had the following features like simple, reliable, convenient, low technical requirements, easy to learn and can be widely used.

Chen’s Penetrating-Suture technique is not affected by the texture of the pancreas, pancreatic remnant size and the pancreatic duct; they wrote.

They explained that the apposition suture of the pancreas and jejunum is neat and facilitate healing with good hemostatic effect.

Further investigations are warranted with more extensive prospective cohort series and prospective randomized studies.

Further reading:

Zhang, L., Zhu, X., Zhu, Y. et al. Chen’s penetrating-suture technique for pancreaticojejunostomy following pancreaticoduodenectomy. BMC Surg 23, 146 (2023). https://doi.org/10.1186/s12893-023-02054-y