Comparing two pancreaticojejunostomy methods on the pancreatic fistula rates after laparoscopic pancreaticoduodenectomy
10.3760/cma.j.cn113884-20201202-00610
- VernacularTitle:胰肠吻合方式对腹腔镜胰十二指肠切除术后胰瘘发生率的影响
- Author:
Cheng ZHANG
1
;
Dongjun AN
;
Yang WANG
;
Lin YANG
;
Jintao WANG
;
Li HAN
;
Baoguo ZHAO
;
Yao XU
;
Boqiang HAN
Author Information
1. 西安交通大学医学部附属咸阳市中心医院肝胆外科，咸阳 712000
- Keywords:
Pancreaticoduodenectomy;
Laparoscopy;
Pancreatic fistula;
Pancreatojejunostomy
- From:
Chinese Journal of Hepatobiliary Surgery
2021;27(8):610-613
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the embedding anastomosis with the intermittent eversion anastomosis on the pancreatic fistula rates after laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 116 patients who underwent LPD at the Center Hospital of Xianyang City affiliated to Xi' an Jiaotong University Health Science Center from March 2016 to March 2020 were retrospectively studied. According to the method of pancreaticojejunostomy used, these patients were divided into the following two groups: the embedding anastomosis group ( n=55) and the intermittent eversion anastomosis group ( n=61). The duration of pancreaticojejunostomy, bilioenterostomy and gastrointestinal anastomoses, and the amounts of intraoperative blood loss and postoperative complication rates were compared between the two groups. Results:Of 116 patients in this study, there were 67 males and 49 females, with a median age of 61.5 years. No perioperative death occurred in the 2 groups. The operation time, digestive tract reconstruction time and pancreaticojejunostomy time in the embedded anastomosis group were (260±20), (65±15) and (35±15) min, respectively, which were significantly lower than those in the intermittent eversion anastomosis group (305±25), (81±25) and (45±12) min, (all P<0.05). The grade A and B pancreatic fistula rates in the embedded anastomosis group were 27.3%(15/55) and 21.8%(12/55), respectively, which were significantly higher than those in the intermittent eversion anastomosis group [8.2%(5/61) and 6.6%(4/61)], (all P<0.05). The postoperative hospital stay in the intermittent eversion anastomosis group (10.3±1.1) d was significantly lower than that in the embedding anastomosis group [(15.2±3.2) d, P<0.05]. Conclusion:In LPD, when compared with embedded pancreaticojejunostomy, intermittent eversion pancreaticojejunostomy reduced the postoperative pancreatic fistula rate and shortened the postoperative hospital stay.
