Application of a modified pancreatogastric anastomosis in laparoscopic duodenum-preserving pancreatic head resection
10.3760/cma.j.cn113884-20230905-00058
- VernacularTitle:改良的胰胃吻合技术在腹腔镜保留十二指肠的胰头切除术中的应用
- Author:
Jianzhang QIN
1
;
Haotian YU
;
Xueqing LIU
;
Xinbo ZHOU
;
Wei HE
;
Yunfei LIANG
;
Qing ZHANG
;
Jianhua LIU
Author Information
1. 河北医科大学第二医院肝胆外科，石家庄 050000
- Keywords:
Anastomosis;
Surgical;
Laparoscopic duodenum-preserving pancreatic head resection;
Pancreaticojejunostomy;
Pancreatic tumor
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(12):927-931
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the feasibility of a modified pancreatogastric anastomosis in laparoscopic duodenum preserving pancreatic head resection (LDPPHR).Methods:The clinical data of 25 patients with benign or low-grade malignant tumors of pancreatic head undergoing LDPPHR at the Second Hospital of Hebei Medical University from January 2019 to May 2023 were retrospectively analyzed, including 7 males and 18 females, aged (44.9±6.2) years old. According to the methods of pancreatic digestive reconstruction, patients were divided into the observation group ( n=10), who underwent the modified pancreatogastric anastomosis, and the control group ( n=15) who underwent conventional pancreaticojejunal anastomosis and jejuno-jejunal anastomosis. The general data, intraoperative pancreatic digestive reconstruction time, maximum levels of amylase in abdominal drainage within three days postoperatively, postoperative complications, and hospital stay were compared between the groups. Results:All procedures were performed successfully. The intraoperative pancreatic digestive reconstruction time was shorter in the observation group [(27.8±2.4) min vs. (45.8±3.6) min, P=0.010]. The intraoperative blood loss were comparable between the groups [(140.5±14.8) ml vs. (145.2±9.7) ml, P=0.843]. The maximum level of amylase in abdominal drainage within three days postoperatively was lower in the observation group [(809.1±185.5) U/L vs. (1 385.4±481.1) U/L, P=0.031]. No grade C pancreatic fistula or postoperative hemorrhage occurred in either group, and the incidence of grade B pancreatic fistula was lower in the observation group [20.0% (2/10) vs. 60.0% (9/15), P=0.048], with a shorter postoperative hospital stay [(7.9±1.3) d vs. (10.3±2.7) d, P=0.017]. No decrease of life quality or reoperation due to pancreatic fistula, hemorrhage or digestive tract malfunction occurred in either group within a median follow-up of 15.6 months. Conclusion:In LDPPHR, the modified pancreatogastric anastomosis could help shorten the pancreatic digestive reconstruction and lower the risk of postoperative pancreatic fistula.
