The effect of end-to-side pancreaticojejunostomy with pocket insertion on the incidence of pancreatic fistula after operation
10.3760/cma.j.issn.1674-6090.2019.06.011
- VernacularTitle: 荷包套入式胰肠端侧吻合法对术后胰瘘发生率的影响——单中心581例临床经验总结
- Author:
Wei CHAI
1
;
Bao LEI
;
Yu MENG
;
Xiulei ZHAO
;
Lei ZHANG
;
Deshuai KONG
;
Ruhai LIU
Author Information
1. Department of General Surgery, Cangzhou Central Hospital of Hebei Province, Cangzhou 061000, China
- Publication Type:Journal Article
- Keywords:
Pancreatoduodenectomy;
Pancreaticoduodenectomy;
Pancreatic fistula
- From:
Chinese Journal of Endocrine Surgery
2019;13(6):492-496
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effect of end-to-side pancreaticojejunostomy with pocket-insertion on the incidence of pancreatic fistula after pancreaticoduodenectomy.
Methods:The clinical data of 581 patients undergoing pancreaticoduodenectomy from Dec. 2012 to Sep. 2018 in Cangzhou Central Hospital were retrospectively analyzed, including 327 cases of open pancreaticoduodenectomy (OPD) , 175 cases of laparoscopic assisted pancreaticoduodenectomy (LAPD) , and 79 cases of total laparoscopic pancreaticoduodenectomy. End-to-side pancreaticojejunostomy with pocket-insertion was used in all cases. The incidence of pancreatic fistula after operation was analyzed.
Results:The overall incidence of grade B or C pancreatic fistula was 3.10% (18/581) after end-to-side pancreaticojejunostomy with purse-pocket insertion. The incidence of grade B or C pancreatic fistula in OPD group was 2.75% (9/327) . The incidence of grade B or C pancreatic fistula in LAPD group was 2.29% (4/175) . The incidence of grade B or C pancreatic fistula in TLPD group was 6.33% (5/79) . The three groups were divided into two subgroups according to the pancreatic texture. There was significant difference in pancreatic duct diameter between subgroups (P<0.05) , but there was no significant difference in the time of pancreaticojejunostomy and the incidence of pancreatic fistula after operation (P>0.05) .
Conclusion:End-to-side pancreaticojejunostomy with pocket insertion has the advantages of simple operation, strong adaptability, safety and high efficiency, and can control the incidence of pancreatic fistula after pancreaticoduodenectomy at an ideal level.
