Application of Chen′s pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy (116 cases report)
10.3760/cma.j.issn.0529-5815.2020.02.008
- VernacularTitle: 贯穿胰腺纵向"U"形缝合法空肠内翻套入式胰肠吻合技术在腹腔镜胰十二指肠切除术应用（附116例报告）
- Author:
Xinmin YIN
1
;
Yunfeng LI
1
;
Wei CHENG
1
;
Chunhong LIAO
1
;
Yi LIU
1
;
Yifei WU
1
;
Rongyao CAI
1
;
Siwei ZHU
1
;
Sheng LIU
1
;
Shu WU
1
;
Xiaoping CHEN
2
Author Information
1. Department of Hepatobiliary Surgery, Hunan Provincial People′s Hospital, Changsha 410005, China
2. Department of Hepato-Biliary-Pancreatic Surgery Center, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Laparoscopes;
Pancreaticojejunostomy;
Postoperative pancreatic fistula
- From:
Chinese Journal of Surgery
2020;58(2):114-118
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the safety and feasibility of longitudinal transpancreatic U-sutures invaginated pancreatojejunostomy (Chen′s pancreaticojejunostomy technique) in laparoscopic pancreaticoduodenectomy (LPD) .
Methods:Clinical data of 116 consecutive patients who underwent LPD using Chen′s pancreaticojejunostomy technique in Hunan Provincial People′s Hospital from May 2017 to December 2018 were retrospectively analyzed. Among these patients, 66 were males and 50 were females. The median age was 58 years old (32-84 yeas old). All 116 patients underwent pure laparoscopic whipple procedure with Child reconstruction method, using Chen′s pancreaticojejunostomy technique. The intraoperative and postoperative data of patients were analyzed.
Results:All 116 patients underwent LPD successfully. The mean operative time was (260.3±33.5) minutes (200-620 minutes). The mean time of pancreaticojejunostomy was (18.2±7.6) minutes (14-35 minutes) . The mean time of hepaticojejunostomy was (14.6±6.3) minutes (10-25 minutes). The mean time of gastrojejunostomy was (12.0±5.5) minutes (8-20 minutes). The mean estimated blood loss was (106.0±87.6) ml (20-800 ml). Postoperative complications were: 11.2% (13/116) of cases had postoperative pancreatic fistula (POPF) , including 10.3% (12/116) of biochemical fistula and 0.9% (1/116) of grade B POPF, no grade C POPF occurred; 10.3% (12/116) had gastrojejunal anastomotic bleeding; 3.4% (4/116) had hepaticojejunal anastomotic fistula; 3.4% (4/116) had delayed gastric emptying; 4.3% (5/116) had localized abdominal infection; 12.1% (14/116) had pulmonary infection; postoperative mortality were 0(0/116) and 1.7% (2/116) within 30 days and 90 days, respectively. One patient died of massive abdominal bleeding secondary to Gastroduodenal artery pseudoaneurysm rupture, the other patient died of extensive tumor recurrence and metastasis after surgery.
Conclusions:Chen′s pancreaticojejunostomy technique is safe and feasible for LPD.It is an option especially for surgeons who have not completed the learning curve of LPD.
