Application of purse string suture pancreaticojejunostomy for undilated pancreatic duct in total laparoscopic pancreaticoduodenectomy

Background To investigate the feasibility of purse string suture pancreaticojejunostomy in complete laparoscopic pancreaticoduodenectomy for patients with an undilated pancreatic duct. Methods We retrospectively reviewed a database of 113 patients with undilated pancreatic ducts who had undergone laparoscopic pancreaticoduodenectomy (LPD) with purse string suture pancreaticojejunostomy to analyze the perioperative outcomes. Results One hundred thirteen patients underwent successful LPD. The surgery time was 353 +/- 41 min, the time required for pancreaticojejunostomy was 27 +/- 5 min, and the hospital stay after surgery was 16 +/- 8 days. Fifteen patients suffered postoperative complications, including twelve patients with pancreatic fistula, one with bile leakage, one with gastroparesis (complicated with abdominal infection), and one with abdominal bleeding. No perioperative death occurred. Conclusions Purse string suture pancreaticojejunostomy is safe and feasible for patients with an undilated pancreatic duct.