Choices of different pancreaticojejunostomies in patients after pancreaticoduodenectomy
10.3760/cma.j.issn.1007-631X.2014.05.004
- VernacularTitle:胰十二指肠切除术中胰肠吻合方式的选择
- Author:
Wei LIU
;
Rong HUA
;
Wei CHEN
;
Yongwei SUN
;
Zhiyong WU
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Anatosmosis,surgical;
Postoperative complications;
Pancreatic fistula
- From:
Chinese Journal of General Surgery
2014;29(5):340-343
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the pancreaticojejunostomy procedures selection strategy after pancreaticoduodenectomy.Methods The clinical data of 305 cases who received pancreaticoduodenetomy at Shanghai Renji Hospital from Jan 2010 to Jan 2013 were retrospectively analyzed.For patients with pancreatic duct diameter≥3 mm,duct-to-mucosa pancreaticojejunostomy was applied(120 cases).For duct diameter ＜ 3 mm,modified Child pancreaticojejunostomy was applied to 80 cases when pancreatic stump was large,or binding pancreaticojejunostomy procedures was applied to 105 cases while pancreatic stump was small.Results The diameter of the pancreatic stump in modified Child group was significantly larger than that in the binding group (F =5.78,P ＜ 0.05).The overall incidence of pancreatic fistula was 11.1％ (34/305).There were no significant differences in the incidences of pancreatic fistula,peritoneal bleeding,abdominal infection,digestive dysfunction rate,the mean duration of hospital and the death cases among the three groups (x2 =1.51,2.78,1.16,3.75,1.94,F=2.13,P＞0.05).Conclusions Three different pancreaticojejunostomies based on the size of pancreatic duct and pancreatic stump are equally safe and effective as a reconstructive method after pancreaticoduodenectomy.
