Title: invaginated duct to mucosa pancreaticojejunostomy reduced postoperative pancreatic leakage: a matched case-controlled.Stud: the main objective of the study was to assess the potential advantages of invaginated duct to mucosa pancreaticojejunostomy (invaginated d-m pj).All the patients administrated in the first a¨liated hospital to henan university of science and technology during january 2017 to august 2019 who needed pd for malignant tumor.All the operations were completed by the same team.This was a retrospectively designed trial.Finally, 48 pairs of patients were involved in this study.All the operations were performed under general anesthesia.Pancreaticoduodenectomy was performed with local lymph nodes dissection.Jejunal limb was brought up through retrocolic root.After end to side pj, cholangiojejunostomy was performed with 4-0 knotless suture (stratafix, ethicon) by a running suture about 8 cm distal to the pj.Additional jejunojejunostomy was performed by 4-0 knotless suture (stratafix, ethicon) about 10 cm distal to gastrojejunostomy.The difference between the two groups was the procedure of pj.Custom d-m group was performed as modified blumgart anastomoses.Invaginated d-m group was performed as follow: a 3-0 polypropylene suture (prolene, ethicon) was employed to fnish the anastomosis.The suture was strengthened, and duplicated the second suture.When the suture reached to the superior of pancreatic duct, it suspended.Then, duct to mucosa anastomosis was performed as custom d-m by 4-0 polyglactin suture (vicryl plus, ethicon).Reported complications included pancreatic leakage grade a, pancreatic leakage grade b , bleeding , biliary leakage , thrombosis.
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