Analysis of the efficacy and safety of"Double-Suture Four-Needle Technique"for pancreaticojejunostomy in pancreaticoduodenectomy
LIANG Yue-xiang
GAO Song
WANG Xiu-chao
ZHAO Tian-suo
WANG Jian
CHANG Shao-fei
WANG Hong-wei
GAO Chun-tao
HAO Ji-hui
Abstract：Objective To evaluate the clinical efficacy of the"double-suture four-needle technique"for pancreaticojejunostomy in pancreaticoduodenectomy,and compare the differences between the application of this pancreaticojejunostomy to open surgery and laparoscopic surgery.Methods Clinical data of 35 consecutive patients undergoing pancreaticoduodenectomy with the"double-suture four-needle technique"at the Department of Pancreatic Cancer,Tianjin Medical University Cancer Institute and Hospital,between December 2024 and February 2025 were retrospectively analyzed.Perioperative indicators of all patients were analyzed and the differences between the open group(19 cases)and the laparoscopic group(16 cases)were compared.Results All pancreaticojejunostomies were successfully completed using the"double-suture four-needle technique",with a mean anastomosis time of(20.0±8.1)min.Postoperative pancreatic fistula included biochemical pancreatic fistula in 8 cases(22.9％)and Grade B pancreatic fistula in 1 case(2.9％),with no Grade C pancreatic fistula.Clavien-Dindo grade Ⅰ complications occurred in 3 patients and grade Ⅱ complications occurred in 5 patients,all of which recovered with conservative management;no grade Ⅲ or higher complications or mortality were observed.The median tube indwelling time was 9.0(8.0,12.0)d,and median postoperative hospital stay was 12.0(10.0,15.0)d.The laparoscopic group demonstrated a longer pancreaticojejunostomy time[(27.8±3.8)min vs.(13.4±3.2)min,P＜0.001],a shorter postoperative hospital stay[10.5(10.0,13.0)d vs.14.0(11.0,17.0)d,P=0.031)]and a lower postoperative complication rate(0 vs.26.3％,P=0.040)compared to the open surgery group,with statistically significant differences.Conclusion The"double-suture four-needle technique"is a safe and effective method for pancreaticojejunostomy,suitable for both open and laparoscopic pancreaticoduodenectomy.
Keywords：pancreatoenterostomypancreaticoduodenectomypancreatic fistuladouble-suture four-needle technique
Publication Date：2025-05-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 564-569 )