Background : This study aims to evaluate the effect of modified Blumgart anastomosis during pancreaticojejunostomy (PJ) on the incidence of clinically relevant postoperative pancreatic fistula (POPF) after laparoscopic pancreaticoduodenectomy (LPD).

Methods : A retrospective cohort study was conducted on patients who underwent LPD between 2018 and 2022. The primary endpoint was the incidence of grade B and C POPF, classified by the International Study Group on Pancreatic Fistula criteria, and PJ anastomosis time. Secondary endpoints included the incidence of postoperative complications (Clavien-Dindo classification grade ≥ III).

Results : A total of 148 patients were analyzed, comprising 99 in the modified Blumgart group and 49 in the continuous suture group. General and intraoperative characteristics, including pancreas texture (P = 0.397) and pancreatic duct diameter (P = 0.845), showed no significant differences between groups (P > 0.05). Grade B and C POPF occurred in 5 patients (5.1%) in the modified Blumgart group and 3 patients (6.1%) in the continuous suture group (P = 0.781). Postoperative complications (Clavien-Dindo grade ≥ III) were observed in 11 patients (11.1%) in the modified Blumgart group and 4 patients (8.2%) in the continuous suture group. Ninety-day mortality was 2% (n = 2) in the modified Blumgart group and 0% in the continuous suture group. The PJ anastomosis time was significantly shorter in the modified Blumgart group (28.8 ± 5.94 min) compared to the continuous suture group (35 ± 7.71 min; P = 0.003).

Conclusions : The modified Blumgart anastomosis technique during PJ resulted in a shorter anastomosis time while maintaining comparable outcomes to the continuous suture method in LPD.