Comparison of Chen's U-suture technique with duct-to-mucosa anastomosis and traditional invagination pancreaticojejunostomy after pancreaticoduodenectomy: A nationwide cohort study in China

作者：Qi Cheng, Hongwei Huang, Chang Shu, Xia Feng, Baiyong Shen, Xinmin Yin, Xiaoqing Jiang, Deyu Li, Jing Li, Sen Qiao, Songqing He, Heshui Wu, Jiayun Ge, Zhenyu Yin, Guanyu Wang, Haoliang Zhao, Hongxin Ran, Jun Zheng, Guangjun Shi, Jiangtao Yu, Jingfeng Liu, Xiaofeng Liao, Bin Jiang, Weidong Jin, Yan Chen, Zhiwei Zhang, Xiaoping Chen · 发表于：Asian Journal of Surgery · 年份：2025 · DOI：10.1016/j.asjsur.2025.10.062 · 被引用次数：1 · 研究领域：Pancreatic and Hepatic Oncology Research、Gallbladder and Bile Duct Disorders、Minimally Invasive Surgical Techniques

Background Chen's U-suture technique was presented with a low incidence of clinically relevant postoperative pancreatic fistula (CR-POPF) in 2014. This study aimed to compare the outcomes of Chen's U-suture technique with those of duct-to-mucosa and traditional invagination pancreaticojejunostomy. Methods The data of patients who underwent pancreaticoduodenectomy across 21 hospitals between 2014 and 2019 were analyzed and categorized into Chen's group, the duct-to-mucosa (DTM) group, and the traditional invagination (TIG) group. Propensity score matching (PSM) analysis was performed to balance the baseline differences among three groups. Subsequently, the surgical outcomes were compared across the groups. Results After PSM, 1060 patients in each group were matched, resulting in balanced baseline characteristics. The CR-POPF rate was 5.19 % in Chen's group, compared to 8.02 % in the TIG group and 7.45 % in the DTM group ( P= 0.025). A statistically significant difference was identified between Chen's group and the TIG group ( P = 0.034), whereas no significant difference was observed when comparing Chen's group to the DTM group ( P = 0.060). In the subgroup with a small pancreatic duct (≤3 mm), the CR-POPF rate in Chen's group was significantly lower than that in the DTM group (4.6 % vs 7.4 %, P = 0.019). The incidences of intra-abdominal infection and abscess in Chen's group were 7.45 % and 0.47 % respectively, compared to 10.28 % and 2.26 % in the TIG group, and 10.19 % and ...