Articles Vol. 67 No. Số CĐ12- Bệnh viện Ung bướu Nghệ An (2026) 25/08/2026

EARLY OUTCOMES OF MODIFIED BLUMGART PANCREATICOJEJUNOSTOMY REINFORCED WITH THE FALCIFORM LIGAMENT IN PANCREATICODUODENECTOMY

Cao Manh Thau1,2, Cao Manh Thau1,2, Nguyen Van Cong1,2, Pham Gia Anh1,2, Vo Thi Huyen Trang1,2, Pham Thanh Tung1,2, Vo Thi Huyen Trang1,2, Bui Tien Cong1,2
1 Viet Duc University Hospital
2 Bệnh viện Hữu nghị Việt Đức
DOI: 10.52163/yhc.v67iCD12.6289
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Keywords
Pancreaticoduodenectomy, pancreaticojejunostomy, modified Blumgart anastomosis, falciform ligament, postoperative pancreatic fistula.
Abstract

Objective: To evaluate the early outcomes of pancreaticojejunostomy using a modified Blumgart technique reinforced with the falciform ligament in patients undergoing pancreaticoduodenectomy.

Methods: A retrospective descriptive study was conducted on 25 patients who underwent pancreaticoduodenectomy with reconstruction using a modified Blumgart pancreaticojejunostomy reinforced with the falciform ligament at the Department of Oncology and Radiotherapy, Viet Duc University Hospital, between May 2023 and December 2023.

Results: The study included 25 patients (12 male, 13 female) with a mean age of 60.32 ± 13.17 years. Pancreatic head tumors were the most common indication (40%). A falciform ligament flap with a mean size of 71.04 × 24.96 mm was used in all patients. Soft pancreatic texture was observed in 68% of cases, and the mean pancreatic duct diameter was 3.12 ± 0.64 mm. Pancreaticojejunostomy was performed using three transpancreatic U-sutures in 92% of patients, with a mean anastomotic time of 24.08 ± 6.15 minutes. The mean operative time was 423.76 ± 116.78 minutes. Biochemical pancreatic fistula (grade A) occurred in 28% of patients, while one patient (4%) developed grade B postoperative pancreatic fistula associated with gastrointestinal bleeding. No cases of biliary leakage, delayed gastric emptying, intra-abdominal hemorrhage, pancreatic parenchymal tearing during anastomosis, intra-abdominal abscess, or postoperative mortality were recorded. The mean hospital stay was 14.72 ± 4.70 days, and favorable outcomes at discharge were achieved in 96% of patients. Univariate analysis identified BMI ≥ 23 kg/m², soft pancreatic texture, operative time > 8 hours, and pancreatic stump thickness > 12 mm as factors associated with postoperative pancreatic fistula.

Conclusions: Pancreaticoduodenectomy with modified Blumgart pancreaticojejunostomy reinforced by the falciform ligament demonstrated favorable early outcomes, with a low rate of clinically relevant postoperative pancreatic fistula and no postoperative mortality.

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