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    "description": "PurposeThe double purse-string telescoped pancreaticogastrostomy (PG) technique has been suggested as an alternative approach to reduce the risk of postoperative pancreatic fistula (POPF). Its efficacity in high-risk situations has not yet been explored. This study compared the incidence of clinically relevant POPF (CR-POPF) between patients with high-risk anastomosis undergoing PG and those undergoing pancreaticojejunostomy (PJ).MethodsFrom 2013 to 2019, 198 consecutive patients with high-risk anastomosis, an updated alternative fistula risk score\u2009>\u200920%, and who underwent pancreatoduodenectomy with the PJ (165) or PG (33) technique were included. Optimal mitigation strategy (external stenting/octreotide omission) was applied for all patients. The primary endpoint was the incidence of CR-POPF.ResultsThe mean ua-FRS was 33%. CR-POPF (grade B/C) was found in 42 patients (21%) and postoperative hemorrhage in 30 (15%); the mortality rate was 4%. CR-POPF rates were comparable between the PJ (19%) and PG (33%) groups (P\u2009=\u20090.062). The PG group had a higher rate of POPF grade C (24% vs. 10%; P\u2009=\u20090.036), longer operative time (P\u2009=\u20090.019), and a higher transfusion rate (P\u2009<\u20090.001), even after a matching process on ua-FRS.In the multivariate analysis, the type of anastomosis (P\u2009=\u20090.88), body mass index (P\u2009=\u20090.47), or main pancreatic duct diameter (P\u2009=\u20090.7) did not influence CR-POPF occurrence.ConclusionsFor patients with high-risk anastomosis, the double purse-string telescoped PG technique was not superior to the PJ technique for preventing CR-POPF.", 
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        "publisher": "Springer Nature", 
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      "high-risk anastomoses", 
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      "CR-POPF", 
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      "single-center case-control study", 
      "alternative Fistula Risk Score", 
      "main pancreatic duct diameter", 
      "relevant postoperative pancreatic fistula", 
      "POPF grade C", 
      "higher transfusion rate", 
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      "longer operative time", 
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      "consecutive patients", 
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    "name": "Double purse-string telescoped pancreaticogastrostomy is not superior in preventing pancreatic fistula development in high-risk anastomosis: a 6-year single-center case\u2013control study", 
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