Clinical outcomes of interlocking main pancreatic duct-jejunal internal bridge drainage in middle pancreatectomy: A comparative study

doi:10.4240/wjgs.v17.i3.102428

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Mar 27, 2025 (publication date) through Feb 24, 2025

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastrointest Surg. Mar 27, 2025; 17(3): 102428
Published online Mar 27, 2025. doi: 10.4240/wjgs.v17.i3.102428

Table 1 Demographics and patient characteristics of the study cohort

	IMPD-J bridge drainage (n = 23)	Duct-to-mucosa pancreaticojejunostomy (n = 30)	χ²/t/z	P value
Age, years, n (%)	57.0 (52.0, 64.0)	61.0 (51.0, 67.0)	0.944	0.345
Male, n (%)	12 (52.2)	15 (50.0)	0.025	0.875
Female, n (%)	11 (47.8)	15 (50.0)
BMI, kg/m²	23.2 (20.4, 24.6)	22.2 (19.6, 23.4)	-1.212	0.225
Smoking, n (%)	7 (30.4)	15 (50.0)	2.053	0.152
Alcohol consumption, n (%)	7 (30.4)	4 (13.3)	2.315	0.128
Hypertension, n (%)	5 (21.7)	8 (26.6)	0.171	0.679
Diabetes, n (%)	10 (43.5)	7 (23.3)	2.425	0.119
WBC, 10⁹/L	5.3 (4.7, 5.8)	5.0 (4.9, 6.1)	0.117	0.907
Neutrophils, 10⁹/L	2.8 (2.5, 3.1)	3.0 (2.6, 3.6)	0.808	0.419
Platelet, 10⁹/L	224.7 ± 63.1	198.3 ± 55.3	1.619	0.112
Albumin, g/L	42.6 ± 3.9	41.9 ± 3.8	0.480	0.633
Prealbumin, mg/dL	20 ± 10	20 ± 10	0.03	0.977
Total bilirubin, μmol/L	11.4 (6.7, 15.9)	11.4 (10.1, 14.5)	0.188	0.851

IMPD-J: Interlocking main pancreatic duct-jejunal; BMI: Body mass index; WBC: White blood cells.

Table 2 Intraoperative data of patients who underwent interlocking main pancreatic duct-jejunal bridge drainage or duct-to-mucosa pancreaticojejunostomy

	IMPD-J bridge drainage (n = 23)	Duct-to-mucosa pancreaticojejunostomy (n = 30)	χ²/t/z	P value
Operation time, hours	4.3 ± 1.3	5.8 ± 1.8	-3.233	0.002
Blood loss, mL	100.0 (50.0, 200.0)	100.0 (87.5, 300.0)	-1.894	0.058
RBC transfusion, u	0 (0, 0)	0 (0, 0)	-0.197	0.843
Plasma transfusion, mL	0 (0, 0)	0 (0, 75.0)	-0.507	0.612
Tumor diameter, cm	4.1 ± 2.3	3.9 ± 1.9	0.303	0.763
Pancreatic duct diameter, mm	3.0 (3.0, 5.0)	3.0 (2.4, 6.0)	-2.420	0.809

IMPD-J: Interlocking main pancreatic duct-jejunal; RBC: Red blood cells.

Table 3 Postoperative outcomes of patients who underwent interlocking main pancreatic duct-jejunal bridge drainage or duct-to-mucosa pancreaticojejunostomy

	IMPD-J bridge drainage (n = 23)	Duct-to-mucosa pancreaticojejunostomy (n = 30)	χ²/t/z	P value
Temperature > 38.5 °C, n (%)	5 (21.7)	5 (16.7)	0.013	0.910
Blood culture (positive), n (%)	0 (0)	2 (6.7)	NA	0.499
Drainage tube infection, n (%)	4 (17.4)	4 (13.3)	NA	0.715
Nasogastric tube retention, days	5.3 ± 1.7	6.5 ± 2.0	-2.218	0.031
DGE, n (%)	2 (8.7)	11 (36.7)	5.502	0.019
Peritoneal effusion, n (%)	1 (4.4)	6 (20.0)	2.782	0.095
Intervention/endoscopic treatment, n (%)	0 (0)	1 (3.3)	NA	1.000
Postoperative bleeding, n (%)	1 (4.4)	1 (3.3)	NA	1.000
Length of hospital stay, days	24.0 (14.0, 29.0)	29 (9.8, 40.3)	-0.844	0.399
Drainage tube retention time, days	20.0 (13.0, 36.0)	27 (17.8, 40.0)	-1.096	0.273
POPF 0, n (%)	6 (26.1)	5 (16.7)	NA	NA
A, n (%)	8 (34.8)	4 (13.3)	NA	NA
B, n (%)	8 (34.8)	21 (70.0)	NA	NA
C, n (%)	1 (4.4)	0 (0)	NA	NA
CR-POPF, n (%)	9 (39.1)	21 (70.0)	5.051	0.025

IMPD-J: Interlocking main pancreatic duct-jejunal; NA: Not available; DGE: Delayed gastric emptying; POPF: Postoperative pancreatic fistula; CR-POPF: Clinically relevant postoperative pancreatic fistula.

Table 4 Univariable binary logistic regression analysis of potential influencing factors for the occurrence of clinically relevant postoperative pancreatic fistula

	OR	95%CI	P value
Age, year	0.971	(0.925, 1.019)	0.229
Gender (ref: Male)	2.034	(0.673, 6.146)	0.208
BMI, kg/m²	1.508	(0.891, 1.257)	0.517
Smoking	0.632	(0.209, 1.907)	0.415
Alcohol consumption	0.567	(0.149, 2.158)	0.405
Diabetes	0.396	(0.121, 1.289)	0.124
Hypertension	0.862	(0.245, 3.003)	0.817
WBC	0.719	(0.439, 1.715)	0.188
Platelet	0.999	(0.990, 1.009)	0.912
Albumin	1.115	(0.956, 1.301)	0.166
Prealbumin	1.111	(0.994, 1.242)	0.063
Total bilirubin	0.911	(0.801, 1.307)	0.158
Operation type (ref: IMPD-J bridge drainage)	3.630	(1.155, 11.406)	0.027
Tumor diameter	0.908	(0.697, 1.183)	0.475
Pancreatic duct diameter	0.912	(0.707, 1.176)	0.477
Bleeding	1.002	(0.999, 1.006)	0.218
Blood transfusion	1.102	(0.665, 1.827)	0.706
Plasma transfusion	1.000	(0.998, 1.002)	0.943

OR: Odds ratios; CI: Confidence interval; BMI: Body mass index; WBC: White blood cells; IMPD-J: Interlocking main pancreatic duct-jejunal.

Table 5 Multivariate logistic regression analysis of independent risk factors for the occurrence of clinically relevant postoperative pancreatic fistula

	OR	95%CI	P value
Operation type (ref: IMPD-J bridge drainage)	4.219	(1.238, 14.379)	0.021
Prealbumin	1.132	(1.001, 1.281)	0.049

OR: Odds ratios; CI: Confidence interval; IMPD-J: Interlocking main pancreatic duct-jejunal.

Citation: Lu XY, Tan XD. Clinical outcomes of interlocking main pancreatic duct-jejunal internal bridge drainage in middle pancreatectomy: A comparative study. World J Gastrointest Surg 2025; 17(3): 102428
URL: https://www.wjgnet.com/1948-9366/full/v17/i3/102428.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i3.102428