Published in:
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
Login to get access
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.