{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T15:42:52Z","timestamp":1763998972190,"version":"3.45.0"},"reference-count":44,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T00:00:00Z","timestamp":1763942400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Introduction: Pancreatico-duodenectomy (PD) remains one of the most complex abdominal surgeries, and pancreatico-jejunostomy (PJ) fistula is its most critical postoperative complication. In efforts to reduce the incidence of postoperative pancreatic fistula (POPF), several PJ techniques and adjuncts, including stents, have been recommended. This article presents data from an international survey regarding PJ methods, the use of pancreatic stents, and their correlation with POPF rates from surgical centers worldwide. Methods: A nine-item online questionnaire was sent globally through social networks, individual mailing lists, and the ASHBPS mailing list. Data were analyzed through the Student\u2019s t-test (two-tailed, unequal variance). A p-value &lt; 0.05 was considered to be statistically significant. Results: A total of 122 units of pancreatic surgery from 26 countries distributed across five continents responded to the survey. Most centers performed less than 50 PDs a year, preferred a duct-to-mucosa PJ, and employed a stent routinely. Mean POPF grade B and C incidences were lower in high-volume (15.24% \u00b1 7.29 and 3.95% \u00b1 2.39) and in PJ stent-using centers (16.25% \u00b1 8.7 and 5.37% \u00b1 7.49). Conclusions: Institutional case volume and stent usage are more crucial determinants of POPF incidence than the PJ technique itself. Centralization and standardization of PD procedures are related to reductions in major fistula rates.<\/jats:p>","DOI":"10.3390\/curroncol32120657","type":"journal-article","created":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T14:59:04Z","timestamp":1763996344000},"page":"657","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pancreatico-Jejunostomy Fistula After Pancreaticoduodenectomy: Where Do We Stand? Results from an International Survey"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-6007-8834","authenticated-orcid":false,"given":"Silvio","family":"Caringi","sequence":"first","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"},{"name":"Department of Surgery, Universit\u00e0 Degli Studi Roma \u201cTor Vergata\u201d, Via Montpellier 1, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-5418","authenticated-orcid":false,"given":"Michele","family":"Tedeschi","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"},{"name":"Department of Medicine and Surgery, LUM University, Casamassima, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7759-4340","authenticated-orcid":false,"given":"Antonella","family":"Delvecchio","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annachiara","family":"Casella","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0997-9425","authenticated-orcid":false,"given":"Cataldo","family":"De Palma","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital, Pancreatic Surgery, Via Alessandro Manzoni 56, 20089 Rozzano, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalinda","family":"Filippo","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Stasi","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4636-3478","authenticated-orcid":false,"given":"Tommaso Maria","family":"Manzia","sequence":"additional","affiliation":[{"name":"Transplant and HPB Unit, Department of Surgery Sciences, University of Rome Tor Vergata, 00133 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1668-932X","authenticated-orcid":false,"given":"Riccardo","family":"Memeo","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Biliary and Pancreatic Surgery, \u201cF. Miulli\u201d General Hospital, Acquaviva delle Fonti, 70021 Bari, Italy"},{"name":"Department of Medicine and Surgery, LUM University, Casamassima, 70010 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s00423-020-01855-6","article-title":"Pancreaticojejunostomy-a review of modern techniques","volume":"405","author":"Olakowski","year":"2020","journal-title":"Langenbecks Arch. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/01.sla.0000217673.04165.ea","article-title":"One Thousand Consecutive Pancreaticoduodenectomies","volume":"244","author":"Cameron","year":"2006","journal-title":"Ann. 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