An bio-artificial dura mater wrapped skeletonized hepatic artery technique in the prevention of post pancreatoduodenectomy delayed gastroduodenal artery stump bleeding
10.3760/cma.j.cn113855-20230613-00312
- VernacularTitle:人工硬脑膜包裹肝动脉技术在预防胰十二指肠切除术后胃十二指肠动脉残端出血中的应用
- Author:
Yusheng DU
1
;
Ji WANG
;
Hongqin MA
;
Li LIU
;
Wenxing ZHAO
Author Information
1. 徐州医科大学附属医院普外科，徐州 221002
- Keywords:
Pancreatoduodenectomy;
Hemorrhage;
Bio-artificial dura mater
- From:
Chinese Journal of General Surgery
2023;38(12):914-919
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and efficacy of using bio-artificial dura mater to wrap around skeletonized hepatic artery during pancreatoduodenectomy in the prevention of gastroduodenal artery(GDA)stump related delayed bleeding.Methods:Clinical data were collected from 45 patients undergoing the bio-artificial dura mater wrapping skeletonized hepatic artery during pancreatoduodenectomy from Oct 2022 to Apr 2023 at Department of General Surgery, the Affiliated Hospital of Xuzhou Medical University.Results:Among the 45 patients, the bio-artificial dura mater was used to completely wrap the GDA stump and part of the common hepatic artery and the proper hepatic artery. The mean operative time was (308.1±93.1) min, the mean wrapping artery time was (18.7±7.5) min. Clinically relevant postoperative grade B pancreatic fistula (CR-POPF) occurred in 6 cases (13.3%), and intra-abdominal infection in 2 cases (4.4%).The rate of bile leakage was 2.2%.There were no second surgical operation, nor perioperative death. Postoperative delayed bleeding occurred in one case (2.2%) on the right hepatic artery branch near the hepatic portal. No pseudoaneurysm formation, nor bleeding occurring in any of the arteries wrapped by bio-artificial dura mater (including the GDA stump) after PD. There were no postoperative hepatic artery wrapping complications, such as hepatic artery stenosis, mesh-associated fluid accumulation and infection.Conclusion:Bio-artificial dura mater wrapping skeletonized hepatic artery technique in the process of pancreaticoduodenectomy can reduce the risk of delayed bleeding due to erosion of GDA stumps in case of post-PD pancreatic fistula.
