A Modified Chen’s U-Suture Technique with or Without a Stent in Pancreaticojejunostomy for Patients with Soft Pancreas and Small Pancreatic Duct: A Multicenter Cohort Study

作者：Qi Cheng, Hongwei Huang, Heshui Wu, Deyu Li, Bin Jiang, Chuang Peng, Bei Sun, Zhiwei Zhang, Xiaoping Chen, Yan Chen · 发表于：Journal of Investigative Surgery · 年份：2025 · DOI：10.1080/08941939.2025.2592929 · 被引用次数：2 · 研究领域：Gallbladder and Bile Duct Disorders、Pancreatitis Pathology and Treatment、Pancreatic and Hepatic Oncology Research

Introduction Chen’s U-suture technique has undergone revisions since it was first devised and has shown low postoperative pancreatic fistula (POPF) rates after pancreaticoduodenectomy (PD). This study aims to evaluate the efficacy of the modified Chen’s U-suture technique among patients with soft pancreas and small pancreatic duct (diameter ≤3mm), either with or without stent placement.Methods Of 1852 patients screened, 198 patients with high-risk anatomy who received the modified Chen’s U-suture technique for PD from 6 hospitals between 2018 and 2024 were included. Patients were classified into the stent (n = 159) and the non-stent group (n = 39) according to whether a pancreatic duct stent was placed. The primary endpoint was to evaluate the rate of POPF.Results Among the patients, four (2.5%) experienced grade B POPF, without grade C POPF occurred. A higher biochemical leak rate was observed in the non-stent group (n = 16, 41.0%) than in the stent group (n = 14, 8.8%) (p < 0.001). No statistically significant difference was found between the two groups in overall complication rates (30.8% vs. 37.7%, p = 0.407).Discussion This technique is reliable for patients with soft pancreas and small pancreatic duct, including those who have ducts too small to undergo stent placement.