Application of the curettage and suction dissection method with PMOD in pancreaticoduodenectomy
10.7659/j.issn.1005-6947.2024.09.012
- VernacularTitle:PMOD刮吸解剖法在胰十二指肠切除术中的应用
- Author:
Yan GUO
1
;
Heyuan NIU
;
Jun LI
;
Xingkai MENG
Author Information
1. 内蒙古医科大学研究生院,内蒙古呼和浩特 010050
- Keywords:
Pancreaticoduodenectomy;
Postoperative Complications;
Peng's Multifunctional Operational Dissector
- From:
Chinese Journal of General Surgery
2024;33(9):1451-1458
- CountryChina
- Language:Chinese
-
Abstract:
Background and Aims:Severe and multiple complications significantly affect the survival of patients after pancreaticoduodenectomy(PD).Previous studies have primarily focused on improving anastomosis techniques to reduce postoperative fistulas,with limited research on anatomical approaches to decrease complications and improve patient outcomes.This article summarizes our team's experience in applying curettage and suction dissection method in PD and analyzes its safety and clinical efficacy. Methods:The clinical data from patients undergoing elective PD in the Department of Hepatobiliary Surgery of Inner Mongolia Medical University Hospital from January 2021 to June 2023 were retrospectively collected.Patients using the curettage and suction dissection method were designated as the observation group,while those using traditional anatomical techniques were served as the control group.The observation group utilized the Peng's multifunctional operational dissector(PMOD),whereas the control group used conventional electrotome and ultrasonic scalpel during operation.The main clinical variables between the two groups were compared,and factors affecting postoperative survival of patients were also analyzed. Results:A total of 169 patients were included,with 59 in the observation group and 110 in the control group.No significant differences in baseline characteristics were found between the groups(all P＞0.05).The observation group exhibited more nerve infiltration during surgery than the control group(64.41％vs.39.09％,P=0.002),but had significantly shorter operative time(236 min vs.330 min,P＜0.01).There were no significant differences in lymph node metastasis,blood loss,or vascular infiltration between the two groups(all P＞0.05).The incidence of postoperative pancreatic fistula was significantly lower in the observation group than that in the control group(16.9％vs.40.0％,P=0.002).No significant differences were noted between the groups in terms of reoperation rate within one month,postoperative hospitalization duration,bile leakage,bleeding,infection,delayed gastric emptying or survival(all P＞0.05).Multivariate Logistic regression analysis identified smoking,tumor nerve infiltration,and delayed gastric emptying as independent risk factors affecting survival(all P＜0.05). Conclusion:Using curettage and suction dissection method with PMOD in PD is safe and feasible.It is simpler,less invasive,and results in shorter operative time compared to traditional method,indirectly reducing postoperative complications.Its clinical efficacy is reliable,suggesting potential for broader application in clinical practice.
