Objective:

To evaluate the safety and feasibility of the modified stent-free Chen's U-suture technique in pediatric pancreatic surgery.

Approach:

• Study Design: Retrospective analysis of clinical data from five children who underwent pancreatic resection using the modified stent-free Chen's U-suture technique.
• Patient Demographics: Five children (2 males, 3 females; aged 4.3–10.1 years) with various pancreatic conditions were included.
• Surgical Technique: The modified stent-free Chen's U-suture technique was employed without the placement of a main pancreatic duct stent.

Key Findings:

• All procedures were successful with a median operative time of 5 hours (range 3–8 hours).
• No clinically relevant postoperative pancreatic fistula (CR-POPF) occurred (0%, 95% CI: 0.0%–52.2%).
• Transient mild hyperamylasemia was observed in two patients, managed conservatively.
• No infections, hemorrhages, reoperations, or readmissions were reported.
• Long-term follow-up showed one child required pancreatic enzyme replacement for fat malabsorption.

Interpretation:

The modified stent-free Chen's U-suture technique achieved a 0% CR-POPF rate in this small cohort.

Limitations:

• Small sample size limits generalizability.
• Short follow-up duration for some patients may not capture long-term outcomes.

Conclusion:

The technique resulted in low complication rates and manageable transient hyperamylasemia.