The safety and efficiency of the Blumgart anastomosis in pancreaticojejunostomy after pancreaticoduodenectomy
10.3760/cma.j.issn.1007-8118.2013.11.007
- VernacularTitle:Blumgart吻合在胰十二指肠切除术后胰肠吻合中的应用
- Author:
Xinjing ZHANG
;
Wei ZHANG
;
Ti ZHANG
;
Yunlong CUI
;
Huikai LI
;
Tianqiang SONG
;
Qiang LI
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Pancreaticojejunostomy;
Pancreatic fistula
- From:
Chinese Journal of Hepatobiliary Surgery
2013;19(11):831-835
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the impact of the Blumgart anastomosis in pancreaticojejunostomy on the incidence of postoperative pancreatic fistula (POPF) after pancreaticoduodeneetomy (PD),and to study its safety and efficacy.Methods A total of 205 patients who underwent PD between January 2011 and February 2013 were retrospectively studied.The patients were divided into three groups depending on the pancreaticoenteric reconstruction:the Blumgart anastomosis group (n=37),the duct-to-mucosa anastomosis group (n =39) and the traditional invagination group (n=129).Postoperative morbidity were analyzed.Results The incidences of POPF after the Blumgart anastomosis (8.1％) was significantly lower than the duct-to-mucosa anastomosis group (23.1％ ; P=0.037) and the traditional invagination anastomosis group (30.2％ ; P=0.012).Multivariate analysis revealed soft pancreatic texture,pancreatic duct diameter ＜3 mm and non-Blumgart anastomosis were independent risk factors of POPF.On subgroup analysis,the Blumgart anastomosis was superior to the duct-to-mucosa anastomosis in patients with pancreatic duct diameter ＜ 3 mm (P=0.038),and showed advantages over the traditional invagination anastomosis in patients with soft pancreatic texture (P =0.001),as well as in patients with pancreatic duct diameter ＜ 3 mm (P=0.011).Conclusions The Blumgart anastomosis is a safe technique,and it could significantly reduced the rate of POPF.It should be routinely used for pancreatoenteric reconstruction after PD.
