{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T01:59:07Z","timestamp":1773885547536,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T00:00:00Z","timestamp":1529366400000},"content-version":"tdm","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":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To prevent leakage of pancreatic juice from the main pancreatic duct (MPD), complete external drainage appears to be the most effective technique. However, because this requires a pancreatic stent tube to be ligated with MPD, duct\u2010to\u2010mucosa pancreaticojejunostomy (PJ) is difficult. From our histopathological examination, a large amount of pancreatic juice is drained from the ducts other than MPD. This study aimed to evaluate our new conceptual technique of PJ after pancreaticoduodenectomy (PD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We considered it important to drain pancreatic juice from the branch pancreatic ducts to the intestinal tract and to perform duct\u2010to\u2010mucosa PJ, while pancreatic juice from MPD is completely drained out of the body. We designed a technique that could simultaneously achieve these points. In our technique, which is based on conventional \u201ctwo\u2010row\u201d anastomosis, a stent tube is fixed with MPD and its surrounding tissue by purse\u2010string suture at the cut surface of the pancreas, and duct\u2010to\u2010mucosa PJ is concomitantly performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 45 patients undergoing PD, 12 of soft pancreas underwent surgery with this technique. According to the classification of the International Study Group on Pancreatic Fistula, a Grade A PF was observed in four patients, whereas no patient had a Grade B or C PF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We propose our anastomotic technique that could simultaneously prevent PF and keep the pancreatic duct patent.\n<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-018-4718-3","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T17:27:03Z","timestamp":1529429223000},"page":"4090-4096","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Proposal for a Safe and Functional Pancreaticojejunostomy Technique from a Histopathological Perspective"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9402-4270","authenticated-orcid":false,"given":"Akira","family":"Mitsuyoshi","sequence":"first","affiliation":[{"name":"Department of Surgery Otsu City Hospital 2\u20109\u20109 Motomiya 520\u20100804 Otsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinshichi","family":"Hamada","sequence":"additional","affiliation":[{"name":"Department of Pathology Otsu City Hospital Otsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidenori","family":"Ohe","sequence":"additional","affiliation":[{"name":"Department of Surgery Otsu City Hospital 2\u20109\u20109 Motomiya 520\u20100804 Otsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruku","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Surgery Otsu City Hospital 2\u20109\u20109 Motomiya 520\u20100804 Otsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Okabe","sequence":"additional","affiliation":[{"name":"Department of Surgery Otsu City Hospital 2\u20109\u20109 Motomiya 520\u20100804 Otsu Shiga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenta","family":"Inoguchi","sequence":"additional","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery and Organ Transplantation, Department of Surgery Kyoto University Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,19]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i46.17491"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.06.008"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v11.i16.2456"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010004\u20107507\u20100"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00311562"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.6634"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800680406"},{"key":"e_1_2_9_10_2","first-page":"685","article-title":"Modified gastrointestinal reconstruction after pancreaticoduodenal resection with particular reference to the 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