Modified invaginated pencreaticojejunostomy approach in pancreaticoduodenectomy: Jiang's anastomosis
10.3760/cma.j.issn.1007-8118.2017.06.010
- VernacularTitle:一种极简主义改良胰肠内陷式(Jiang式)吻合法的临床研究
- Author:
Bin LI
;
Xiangji LUO
;
Bin YI
;
Chen LIU
;
Xiaobing WU
;
Yong YU
;
Qingbao CHENG
;
Feiling FENG
;
Chang XU
;
Zhiquan QIU
;
Baihe ZHANG
;
Xiaoqing JIANG
- Keywords:
Jiang's anastomosis;
Pancreaticoduodenectomy;
Pancreaticojejunostomy;
Pancreatic fistula;
Risk factor
- From:
Chinese Journal of Hepatobiliary Surgery
2017;23(6):395-400
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the clinical feasibility and safety of modified invaginated pencreaticojejunostomy approach (Jiang's anastomosis) which was developed by the team of biliary surgery department from Shanghai Eastern Hepatobiliary Surgery Hospital.Methods Clinical data of 289 patients receiving modified invaginated pencreaticojejunostomy approach in pancreaticoduodenectomy were retrospectively studied.Wilcoxon signed-rank test,Chi-square and logistic regression tests were comprehensively used to evaluate the postoperative complications and the association with POPF.Results One hundred and sixtythree of 289 patients (54.6％) experienced postoperative complications after pancreaticoduodenectomy procedure.There were 45 onsets of severe complications,accounted for 17.6％ (45/255).Perioperative mortality was 3.1％ (9/289).The most common complications included celiac effusion and infection (26.6％),delayed gastric emptying (17.6％),gastroenterological tract fistula (12.4％),gastroenterological tract hemorrhage (9.7％).Additionally,the incidence of POPF was 9.3％,which all conformed as biochemical fistula (6.9％) and grade-B fistula (2.4％).Conclusions As a risk factor,POPF may play crucial role in celiac hemorrhage and infection associated with pancreaticoduodenectomy.Modified invaginated pencreaticojejunostomy approach (Jiang's anastomosis) with easy manipulation,wide indication,safe and effective performance,could be recommended to reduce POPF incidence.
