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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2014

01-12-2014 | Pancreatic Tumors

Chen’s U-Suture Technique for End-to-End Invaginated Pancreaticojejunostomy Following Pancreaticoduodenectomy

Authors: Xiao-ping Chen, MD, FACS, FASA (hoc), Zhi-yong Huang, MD, Josef W. Y. Lau, MD, Bi-xiang Zhang, MD, Zhi-wei Zhang, MD, Yi-fa Chen, MD, Wan-guang Zhang, MD, Peng Zhu, MD, Binhao Zhang, MD

Published in: Annals of Surgical Oncology | Issue 13/2014

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Abstract

Background and Purpose

Internationally, postoperative pancreatic fistula (POPF) remains a leading cause of morbidity and mortality after pancreaticoduodenectomy (PD). In order to reduce the incidence of POPF, a number of technical modifications for pancreato-enteric anastomosis after PD have been proposed. In 1995, we established a new technique with transpancreatic transverse U-sutures for end-to-end invaginated pancreaticojejunostomy after a PD, and the preliminary results were quite encouraging. This study aims to review a new surgical approach, the Chen’s U-stitch technique, for end-to-end invaginated pancreaticojejunostomy, which involves two to four transpancreatic transverse U-sutures, and to evaluate the effectiveness of this approach with reducing the incidence of POPF formation.

Methods

To evaluate this new approach, during 2002–2012, a total of 264 patients who received the new Chen’s U-stitch technique after a PD were included in this study. Postoperative morbidity and mortality, including the incidence of POPF, were analyzed.

Results

Postoperative morbidity was 22.3 % (59/264) and mortality was 0 % (0/264). The POPF rate was 3.4 % (9/264) for Grade A, 0.8 % (2/264) for Grade B, and 0 % (0/264) for Grade C.

Conclusions

This new surgical technique (Chen’s U-stitch), which involves an end-to-end invaginated pancreaticojejunostomy with two to four transpancreatic transverse U-sutures, provides excellent outcomes at reducing the incidence of POPF after PD.
Appendix
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Metadata
Title
Chen’s U-Suture Technique for End-to-End Invaginated Pancreaticojejunostomy Following Pancreaticoduodenectomy
Authors
Xiao-ping Chen, MD, FACS, FASA (hoc)
Zhi-yong Huang, MD
Josef W. Y. Lau, MD
Bi-xiang Zhang, MD
Zhi-wei Zhang, MD
Yi-fa Chen, MD
Wan-guang Zhang, MD
Peng Zhu, MD
Binhao Zhang, MD
Publication date
01-12-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 13/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3823-2

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