Chen X, Wang CY, Fu RB, Liu ZY, Yin MQ, Zhu JH. Binding and interlocking pancreaticojejunostomy vs duct to mucosa pancreaticojejunostomy: A retrospective cohort study. World J Gastrointest Surg 2025; 17(8): 107228 [DOI: 10.4240/wjgs.v17.i8.107228]
Corresponding Author of This Article
Jin-Hui Zhu, PhD, Professor, Department of General Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. 2512016@zju.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xi Chen, Chong-Yu Wang, Zi-Yu Liu, Meng-Qiu Yin, Jin-Hui Zhu, Department of General Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Rui-Biao Fu, Department of Hepatobiliary, Pancreatic and Spleen Surgery, The People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530000, Guangxi Zhuang Autonomous Region, China
Co-first authors: Xi Chen and Chong-Yu Wang.
Author contributions: Chen X, Fu RB, and Zhu JH designed the study; Chen X and Wang CY contributed to data analysis, data interpretation, manuscript drafting, and contributed equally to this work as co-first authors; Fu RB, Liu ZY and Yin MQ contributed to data acquisition. All authors have read and approved the final version of the manuscript.
Supported by National Natural Science Foundation of China, No. 82272634 and No. 62233016.
Institutional review board statement: This study was approved by the Ethics Committee of The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 20231060, and conducted in accordance with the Declaration of Helsinki.
Informed consent statement: Written informed consent was obtained from all participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: There is no additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Hui Zhu, PhD, Professor, Department of General Surgery, The Second Affiliated Hospital Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. 2512016@zju.edu.cn
Received: March 26, 2025 Revised: April 15, 2025 Accepted: June 27, 2025 Published online: August 27, 2025 Processing time: 151 Days and 19.4 Hours
Abstract
BACKGROUND
Pancreatic surgery has markedly evolved during the past several years with the development of minimally invasive techniques such as laparoscopy. pancreaticojejunostomy (PJ), also known as pancreatoenterostomy, is a critical step in surgical reconstruction after pancreatic resection. However, the laparoscopic performance of PJ presents additional technical challenges, especially in achieving a secure anastomosis while preserving the integrity of pancreatic tissue.
AIM
To evaluate the effectiveness and safety of binding and interlocking PJ (BIPJ) as a novel technique in laparoscopic pancreatic surgery.
METHODS
Data of patients who underwent laparoscopic pancreatic surgery from 2018 to 2023 were obtained from the hepatobiliary and pancreatic surgery database of the Second Affiliated Hospital of Zhejiang University School of Medicine and retrospectively analyzed. According to the different PJ methods used during surgery, the patients were divided into two groups: The BIPJ group and the duct-to-mucosa PJ (DMPJ) group.
RESULTS
BIPJ was performed in 33 patients, and DMPJ was performed in 34 patients. The operative time was significantly shorter in the BIPJ group (median, 340 minutes; interquartile range, 310-350) than in the DMPJ group (median, 388 minutes; interquartile range, 341-464) (P = 0.004). No significant differences were found between the DMPJ and BIPJ groups in terms of the rates of pancreatic fistula, intra-abdominal hemorrhage, intra-abdominal abscess, postoperative biliary fistula, reoperation, or postoperative hospital stay.
CONCLUSION
The suitability of laparoscopic PJ for all pancreatic textures, ability to perform full laparoscopy, shorter operation time, and comparable safety with traditional PJ make BIPJ a promising option for both surgeons and patients.
Core Tip: This study introduces binding and interlocking pancreaticojejunostomy (BIPJ) as a novel technique for pancreatic surgery, comparing it with traditional duct-to-mucosa pancreaticojejunostomy. BIPJ demonstrated a significantly shorter operative time (median 340 vs 388 minutes, P = 0.004) while maintaining comparable safety profiles, including similar rates of postoperative pancreatic fistula and other complications. The technique’s adaptability to all pancreatic textures and suitability for laparoscopy make it a promising advancement. These findings suggest that BIPJ could enhance surgical efficiency without compromising patient outcomes, warranting further prospective validation.
