{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T22:13:20Z","timestamp":1779920000080,"version":"3.53.1"},"reference-count":25,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2016,8,8]],"date-time":"2016-08-08T00:00:00Z","timestamp":1470614400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2016,8,8]],"date-time":"2016-08-08T00:00:00Z","timestamp":1470614400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Duct\u2010to\u2010mucosa pancreatojejunostomy after pancreatoduodenectomy can be technically difficult, particularly in cases with a non\u2010dilated pancreatic duct. We devised a novel procedure employing a pancreatic duct holder and mucosa squeeze\u2010out technique facilitating duct\u2010to\u2010mucosa anastomosis. We compared the perioperative outcomes of pancreatoduodenectomy with duct\u2010to\u2010mucosa pancreatojejunostomy between the novel and conventional procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our pancreatic holder has a cone\u2010shaped tip with a slit. The holder can expand the pancreatic duct and provides a good surgical field for anastomosis. A small incision for anastomosis is made on the jejunum, while the jejunum is grasped around the incision. Then, the jejunal mucosa becomes squeezed\u2010out and everted. This mucosa squeeze\u2010out technique facilitates suturing the full thickness of the jejunum. Propensity score matching yielded 113 cases each undergoing the novel and the conventional procedure, among 308 cases receiving pancreatoduodenectomy with duct\u2010to\u2010mucosa pancreatojejunostomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall morbidity rate was significantly lower in the novel procedure group. The pancreatic fistula (ISGPF grade B\/C) rate was significantly lower in the novel (5 %) than in the conventional (13 %) procedure group. For cases with a non\u2010dilated pancreatic duct (\u22643\u00a0mm), the rate was significantly lower in the novel (10 %) than in the conventional procedure group (24 %). Multivariate analysis identified a non\u2010dilated pancreatic duct, soft pancreas, and the conventional procedure as factors independently predicting the complication of pancreatic fistula formation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our novel procedure facilitates duct\u2010to\u2010mucosa pancreatojejunostomy and decreases the pancreatic fistula rate. This procedure is simple, rational, and useful for achieving anastomosis, particularly in cases with a non\u2010dilated pancreatic duct.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-016-3659-y","type":"journal-article","created":{"date-parts":[[2016,8,8]],"date-time":"2016-08-08T17:57:37Z","timestamp":1470679057000},"page":"3021-3028","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Pancreatic Duct Holder and Mucosa Squeeze\u2010out Technique for Duct\u2010to\u2010Mucosa Pancreatojejunostomy After Pancreatoduodenectomy: Propensity Score Matching Analysis"],"prefix":"10.1002","volume":"40","author":[{"given":"Masanori","family":"Sugiyama","sequence":"first","affiliation":[{"name":"Department of Surgery Kyorin University School of Medicine 6\u201020\u20102 Shinkawa 181\u20108611 Mitaka Tokyo 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