Comparison of the preserving or removing jejunal mucosa pancreatico-jejunal invaginated anastomosis in pancreatoduodenectomy
10.3760/cma.j.issn.1673-4203.2013.09.007
- VernacularTitle:保留与去空肠黏膜的胰肠套入吻合方式在胰十二指肠切除术中的应用比较
- Author:
Libin WANG
;
Siyuan CHEN
;
Qian QIN
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Pancreatico-jejunal invaginated anastomosis;
Pancreatic fistula;
Postoperative complications;
Hemorrhage
- From:
International Journal of Surgery
2013;40(9):592-595,封3
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluated the preserving or removing jejunal mucosa pancreatico-jejunal invaginated anastomosis in pancreaticoduodenectomy.Methods Between February 2003 and December 2012,58 patients underwent pancreaticoduodenectomy using pancreaticojejunal invaginated anastomosis in our department.In group A,28 patients received pancreatico-jejunal invaginated anastomosis using jejunum preserving technique.Briefly,3 to 4 cm remanent pancreas was inserted into jejunum and thc jcjunum was bundled up using No.7 silk thread at 2 to 3 cm distant to the cutting surface of the pancreas.In group B,30 patients received pancreatico-jejunal invaginated anastomosis using jejunum removing technique.Briefly,the jejunum mucosa was everted and the proximal 3 cmlong mucosa was removed.Then the everted jejunum was re-positioned and the ending of the jejunum was interruptedly sutured to the remanent pancreas.Finally,the covered jejunum was tied up as the group A.Results The pancrcatico-jejunal anastomosis time was 36 ±0.34 minutes shorter in group A than group B (P ＜0.001).The incidence of pancreatic fistula was higher in group B (20.0％) than group A (0％).In contrast,the incidence of post-operative pancreatic bleeding was compared between the two groups (3.6％ vs 3.3％,P =1.000).Conclusions Preserving ejunum mucosa pancreatico-jejunal invaginated anastomosis was unaffected by pancreatic texture pancreatic duct size and position.This method takes the advantages of simple operation and reducing the incidence of pancreatic fistula.
