title: Pancreatojejunostomy with modified purse-string suture technique.
abstract: OBJECTIVE
  Despite many efforts, pancreatic fistula remains the most troublesome complication following pancreatic resections, especially in case of anastomosis made with soft pancreatic tissue. The purpose of the authors was to show their modification of purse-string pancreatodigestive anastomosis and the results obtained.
  
  
  METHODS
  Between January 2013 and June 2015, the technique was applied in 49 patients; one purse-string suture and two U-shaped mattress sutures were used to create the pancreatojejunal anastomosis. In case of soft pancreatic parenchyma, an external stent was temporarily left in the main pancreatic duct. The most frequent pathology was pancreatic cancer, and a pylorus-preserving Whipple procedure was mostly done.
  
  
  RESULTS
  Postoperative early morbidity rate was 35 %. There were two fistulas, one grade A fistula from a fibrotic pancreas (4.2 %) and one grade B in case of a soft pancreas (4 %). However, there was no reoperation and mortality.
  
  
  CONCLUSIONS
  According to favorable results, the modification of the purse-string suture technique makes this method even safer.
authors: Department of Surgery, Clinical Centre, University of Pécs, Ifjúság útja 13., 7624, Pécs, Hungary. kelemende@gmail.com.
authors: Dezső
authors: D
authors: Kelemen
authors: Department of Surgery, Clinical Centre, University of Pécs, Ifjúság útja 13., 7624, Pécs, Hungary.
authors: Róbert
authors: R
authors: Papp
authors: Department of Surgery, Clinical Centre, University of Pécs, Ifjúság útja 13., 7624, Pécs, Hungary.
authors: Bálint
authors: B
authors: Kaszás
authors: Department of Surgery, Clinical Centre, University of Pécs, Ifjúság útja 13., 7624, Pécs, Hungary.
authors: Zsanett
authors: Z
authors: Bíró
authors: Department of Surgery, Clinical Centre, University of Pécs, Ifjúság útja 13., 7624, Pécs, Hungary.
authors: András
authors: A
authors: Vereczkei
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D010193:Pancreaticojejunostomy; D012189:Retrospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Mattress suture; Pancreatic fistula; Pancreatojejunostomy; Purse-string suture