Evaluation of a new invagination technique of pancreatojejunostomy, the most delicate anastomoses: technical details and results of a personal series

<pre>The treatment of pancreatic stump is a critical step of pancreaticoduodenectomy (PD) because leaks from this anastomosis incur major morbidity and mortality. We describe technical details of a personal invagination pancreatojejunostomy (piPJ) and report on its safety. From October 2008 to October 2016, 401 pancreatic resections were performed, of which 187 were PD. A new invagination pancreaticojejunostomy (PJ) was introduced in November 2010 and used in 84 consecutive patients. Data were retrieved from a prospectively collected Institutional database, and used for present retrospective evaluation of the piPJ. Data were retrieved from a prospectively collected Institutional database, and used for present retrospective evaluation of the piPJ. ISGPFc POPF occurred in 14/84 (17%): grade A in 9/84 (11%), grade B in 4/84 (5%) and grade C in 1/84 (1.2%). On the ISGPSc, POPF rate averaged 6%: grade B in 4/84 (5%) and grade C in 1/84 (1.2%). POPF rate associated with high FRS was 20.0%/7% (ISGPFc/ISGPSc). With low and intermediate FRS, POPFs were 6%/0% (ISGPFc/ISGPSc) and 21%/8% (ISGPFc/ISGPSc) respectively. Re-operation rate was 3.6% (3/84). In-hospital mortality rate was 2.4% (2/84) and specific mortality rate for POPF was 1.2% (1/84).</pre>