Pancreaticojejunostomy with duct-to-mucosa versus invagination techniques: a propensity-score matching analysis based on pancreatic duct size and gland texture

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-10-03 DOI:10.1016/j.amjsurg.2025.116646

Apostolos Gaitanidis , Winifred M. Lo , Rachel A. Burke , Eric C. Feliberti , Elexa P. Rallos , Ashley M. May , Adam N. Akari , Marybeth S. Hughes , Peter J. Fagenholz

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引用次数: 0

Abstract

Background

The superiority of duct-to-mucosa (DTM) and invagination (IVG) techniques for pancreaticoduodenectomy has not been established. This is the largest study to compare their outcomes with granular data regarding parenchymal texture and duct size.

Methods

The NSQIP database for patients undergoing open pancreaticoduodenectomy was investigated. Subgroups were based on pancreatic duct size (<3 mm, 3–6 mm, >6 mm) and gland texture (soft, intermediate, hard). Propensity score matching (PSM) was used. The primary outcome was postoperative pancreatic fistula (POPF).

Results

After PSM, there were no differences in the rates of POPF in any subgroup by duct size or gland texture. When examining secondary outcomes, the IVG group was associated with shorter duration of postoperative drain presence among patients with 3–6 mm ducts.

Conclusions

No differences exist in POPF rates between DTM and IVG techniques in subgroups of patients with similar pancreatic duct size and parenchymal texture. The IVG technique may be associated with earlier drain removal in some patients.

查看原文本刊更多论文

胰空肠吻合术与导管到粘膜的内陷技术：基于胰管大小和腺体结构的倾向评分匹配分析

背景胰十二指肠切除术中导管-粘膜（DTM）和内陷（IVG）技术的优越性尚未确定。这是将其结果与有关实质结构和导管大小的颗粒数据进行比较的最大研究。方法对开放性胰十二指肠切除术患者的NSQIP数据库进行调查。根据胰管大小（3 mm、3 - 6 mm、6 mm）和腺体质地（软、中、硬）进行分组。采用倾向评分匹配（PSM）。主要预后指标为术后胰瘘（POPF）。结果经PSM治疗后，各亚组间腺管大小和腺体结构差异无统计学意义。当检查次要结果时，IVG组与3-6 mm导管患者术后引流时间较短相关。结论在胰管大小和实质结构相似的患者亚组中，DTM和IVG技术的POPF率无差异。在一些患者中，IVG技术可能与早期引流术有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.