Standardized pancreaticojejunostomy by double U-stitch technique in open, laparoscopic, and robotic pancreatoduodenectomies

Abstract

To evaluate the efficacy and safety of the Double U-Stitch technique in open, laparoscopic and robotic pancreaticoduodenectomy. A retrospective study was conducted involving 180 patients who underwent pancreaticoduodenectomy (PD) at the Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, between November 2021 to December 2023. Patients were categorized into three groups: open pancreaticoduodenectomy (OPD), laparoscopic pancreaticoduodenectomy (LPD), and robotic pancreaticoduodenectomy (RPD). The Double U-Stitch technique was applied in all cases and perioperative data were collected. All Double U-Stitch techniques were completed according to the standard, whether in the OPD group, LPD group, or RPD group. The average pancreaticojejunal anastomosis time was less than 25min (14.5min in the OPD group, 24.2min in the LPD group and 24.4min in the RPD group, P ​< ​0.0001). The incidence of clinically relevant pancreatic fistula was 11.6% in OPD group and 9.5% in minimally invasive group (LPD ​+ ​RPD) (P ​> ​0.05). There was a low incidence rate of postoperative complications which consisted of bile leak, intra-abdominal infection, hemorrhage, and delayed gastric emptying. There was no 90-day mortality observed. The Double U-Stitch technique demonstrated comparable safety and efficacy across different surgical approaches for PD.