Sun Y, Yu XF, Yao H, Xu S, Ma YQ, Chai C. Safety and feasibility of modified duct-to-mucosa pancreaticojejunostomy during pancreatoduodenectomy: A retrospective cohort study. World J Gastrointest Surg 2023; 15(9): 1901-1909 [PMID: 37901736 DOI: 10.4240/wjgs.v15.i9.1901]
Corresponding Author of This Article
Chen Chai, MBBS, MD, Chief Doctor, Professor, Surgeon, Department of General Surgery, The People’s Hospital of Suzhou New District, No. 95 Huashan Road, High-tech Zone, Suzhou, Suzhou 215000, Jiangsu Province, China. chaich@lzu.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/
World J Gastrointest Surg. Sep 27, 2023; 15(9): 1901-1909 Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.1901
Safety and feasibility of modified duct-to-mucosa pancreaticojejunostomy during pancreatoduodenectomy: A retrospective cohort study
Yi Sun, Xiao-Feng Yu, Han Yao, Shi Xu, Yu-Qiao Ma, Chen Chai
Yi Sun, Xiao-Feng Yu, Han Yao, Shi Xu, Yu-Qiao Ma, Chen Chai, Department of General Surgery, The People’s Hospital of Suzhou New District, Suzhou 215000, Jiangsu Province, China
Author contributions: Sun Y and Chai C contributed to conceptualization; Yao H and Yu XF contributed to investigation; Ma YQ and Xu S contributed to data curation; Sun Y contributed to writing – original draft preparation; Sun Y and Chai C contributed to writing – review & editing; All authors read and approved the final manuscript.
Supported byClinical Medical Science and Technology Development Foundation of Jiangsu University, No. JLY2021118; Science and Technology Project of Suzhou City, No. SKJY2021039.
Institutional review board statement: This retrospective study conformed with the ethical guidelines of the Declaration of Helsinki and was approved by the Institutional Review Board of The People’s hospital of Suzhou New District.
Informed consent statement: Written informed consent was obtained from all the subjects involved in this study.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement-checklist of the manuscript was prepared and revised according to the Statement- checklist of items.
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: Chen Chai, MBBS, MD, Chief Doctor, Professor, Surgeon, Department of General Surgery, The People’s Hospital of Suzhou New District, No. 95 Huashan Road, High-tech Zone, Suzhou, Suzhou 215000, Jiangsu Province, China. chaich@lzu.edu.cn
Received: May 20, 2023 Peer-review started: May 20, 2023 First decision: July 8, 2023 Revised: July 20, 2023 Accepted: August 4, 2023 Article in press: August 4, 2023 Published online: September 27, 2023 Processing time: 125 Days and 1.3 Hours
ARTICLE HIGHLIGHTS
Research background
Pancreatoduodenectomy (PD) is widely used as an effective surgical treatment for pancreatic tumors, but there is currently no consensus on how to effectively prevent postoperative complications, especially pancreatic fistula. How to prevent postoperative pancreatic fistula (POPF) is a current research hotspot and our research focuses on how to solve this problem by improving surgical methods
Research motivation
To demonstrate the safety and feasibility of modified duct-to-mucosa pancreaticojejunostomy (PJ) during PD, especially in the terms of preventing POPF.
Research objectives
To identify independent risk factors for POPF and evaluate the clinical outcomes of two anastomotic techniques (end-to-side invagination PJ versus modified duct-to-mucosa PJ).
Research methods
This stud was a retrospective cohort study which collected and analyzed the information of patients undergoing PD in our hospital. Univariate analysis and multivariate logistic regression analysis were used to analyze the risk factors of POPF and subgroup analysis were conducted to compare the different outcomes between end-to-side invagination PJ and modified duct-to-mucosa PJ.
Research results
Anastomotic approaches, main pancreatic duct (MPD) diameter and pancreatic texture were proven to be significantly associated with the incidence of POPF. And modified duct-to-mucosa PJ could significantly decrease the POPF incidence (11.2%) and operation time (283.4 min) in patients compared with traditional end-to-side invagination.
Research conclusions
Modified duct-to-mucosa PJ had advantages of shorter operation time and lower POPF incidence over classic end-to-side invagination PJ. Additionally, we found that anastomotic approaches, MPD diameter and pancreatic texture were major risk factors for POPF development.
Research perspectives
Modified duct-to-mucosa PJ is effective and safe according to preliminary outcomes. It is an innovative anastomotic technique with great application prospects in PD and also has broad application prospects in future robotic or minimally invasive operations of pancreatic tumors.
