Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy

Abstract Background Pancreaticojejunostomy (PJ) is the key step in laparoscopic pancreaticoduodenectomy (LPD), the quality of which directly affects the incidence of postoperative pancreatic fistula (POPF). Soft pancreatic texture and a small main pancreatic duct (MPD) are risk factors for POPF, whi...

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Main Authors: Yuan Zhu, Jin Yu, Xiaoyun Li, Hongbo Wang, Huapeng Sun, Yongjun Chen, Xiaogang Li, Xiaofeng Liao
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02984-9
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author Yuan Zhu
Jin Yu
Xiaoyun Li
Hongbo Wang
Huapeng Sun
Yongjun Chen
Xiaogang Li
Xiaofeng Liao
author_facet Yuan Zhu
Jin Yu
Xiaoyun Li
Hongbo Wang
Huapeng Sun
Yongjun Chen
Xiaogang Li
Xiaofeng Liao
author_sort Yuan Zhu
collection DOAJ
description Abstract Background Pancreaticojejunostomy (PJ) is the key step in laparoscopic pancreaticoduodenectomy (LPD), the quality of which directly affects the incidence of postoperative pancreatic fistula (POPF). Soft pancreatic texture and a small main pancreatic duct (MPD) are risk factors for POPF, which also increase surgeons’ difficulty with PJ. Chen’s pancreaticojejunostomy is simple, feasible, and reproducible. This study aims to evaluate the clinical effects of Chen’s pancreaticojejunostomy for patients with soft pancreas texture and a small MPD in LPD. Methods The clinical data of 112 patients who underwent LPD with Chen’s pancreaticojejunostomy in Xiangyang Central Hospital from February 2018 to December 2023 were analyzed retrospectively. Summarize and evaluate the critical clinical indicators and postoperative complications during the perioperative period. Results All 112 patients successfully underwent LPD. The median operation time was 300 min, the median PJ time was 27 min, and the median intraoperative blood loss was 100 ml. 8 patients (7.1%) had POPF, all of which had grade B POPF, and no grade C POPF occurred. Postoperative mortality was 1.8% (2/112) within 90 days, and no patient died due to POPF. Among 45 cases (40.2%) with soft pancreatic texture, five patients (11.1%) developed POPF. Among 41 patients (36.6%) with a diameter of MPD ≤ 3 mm, four patients (9.8%) developed POPF. The texture of the pancreas and the diameter of MPD did not affect postoperative complications (P > 0.05). Conclusions Chen’s pancreaticojejunostomy is simple, safe and reliable, which is suitable for the condition of soft pancreatic texture or the small MPD.
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spelling doaj-art-2e1a987fe56842e69aadc1b1143022ee2025-08-20T03:25:16ZengBMCBMC Surgery1471-24822025-06-0125111110.1186/s12893-025-02984-9Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomyYuan Zhu0Jin Yu1Xiaoyun Li2Hongbo Wang3Huapeng Sun4Yongjun Chen5Xiaogang Li6Xiaofeng Liao7Department of Biliary-Pancreatic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceZhongxiang People’s HospitalDepartment of Biliary-Pancreatic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceDepartment of Biliary-Pancreatic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceDepartment of Biliary-Pancreatic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceDepartment of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Biliary-Pancreatic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceDepartment of Biliary-Pancreatic Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and ScienceAbstract Background Pancreaticojejunostomy (PJ) is the key step in laparoscopic pancreaticoduodenectomy (LPD), the quality of which directly affects the incidence of postoperative pancreatic fistula (POPF). Soft pancreatic texture and a small main pancreatic duct (MPD) are risk factors for POPF, which also increase surgeons’ difficulty with PJ. Chen’s pancreaticojejunostomy is simple, feasible, and reproducible. This study aims to evaluate the clinical effects of Chen’s pancreaticojejunostomy for patients with soft pancreas texture and a small MPD in LPD. Methods The clinical data of 112 patients who underwent LPD with Chen’s pancreaticojejunostomy in Xiangyang Central Hospital from February 2018 to December 2023 were analyzed retrospectively. Summarize and evaluate the critical clinical indicators and postoperative complications during the perioperative period. Results All 112 patients successfully underwent LPD. The median operation time was 300 min, the median PJ time was 27 min, and the median intraoperative blood loss was 100 ml. 8 patients (7.1%) had POPF, all of which had grade B POPF, and no grade C POPF occurred. Postoperative mortality was 1.8% (2/112) within 90 days, and no patient died due to POPF. Among 45 cases (40.2%) with soft pancreatic texture, five patients (11.1%) developed POPF. Among 41 patients (36.6%) with a diameter of MPD ≤ 3 mm, four patients (9.8%) developed POPF. The texture of the pancreas and the diameter of MPD did not affect postoperative complications (P > 0.05). Conclusions Chen’s pancreaticojejunostomy is simple, safe and reliable, which is suitable for the condition of soft pancreatic texture or the small MPD.https://doi.org/10.1186/s12893-025-02984-9PancreaticojejunostomyLaparoscopic pancreaticoduodenectomyPostoperative pancreatic fistulaPostoperative complications
spellingShingle Yuan Zhu
Jin Yu
Xiaoyun Li
Hongbo Wang
Huapeng Sun
Yongjun Chen
Xiaogang Li
Xiaofeng Liao
Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
BMC Surgery
Pancreaticojejunostomy
Laparoscopic pancreaticoduodenectomy
Postoperative pancreatic fistula
Postoperative complications
title Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
title_full Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
title_fullStr Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
title_full_unstemmed Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
title_short Efficacy of Chen’s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
title_sort efficacy of chen s pancreaticojejunostomy for patients with soft pancreatic texture and small main pancreatic duct in laparoscopic pancreaticoduodenectomy
topic Pancreaticojejunostomy
Laparoscopic pancreaticoduodenectomy
Postoperative pancreatic fistula
Postoperative complications
url https://doi.org/10.1186/s12893-025-02984-9
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