A retrospective comparative study of two types of pancreaticojejunostomy in total laparoscopic pancreaticoduodenectomy
10.3760/cma.j.cn113884-20211207-00402
- VernacularTitle:完全腹腔镜胰十二指肠切除术中两种胰肠吻合方式的对比研究
- Author:
Haihua ZHOU
1
;
Shian YU
;
Xiaokang WU
;
Xuemin LI
Author Information
1. 浙江大学医学院附属金华医院肝胆胰外科一区，金华 321000
- Keywords:
Laparoscopy;
Pancreaticoduodenectomy;
Anastomosis, surgical
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(4):245-249
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical outcomes of a double purse-string and bridging technique versus duct-to-mucosal pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.Methods:The clinical data of patients who underwent laparoscopic pancreaticoduodenectomy using the double purse-string and bridging pancreaticojejunostomy technique versus those who underwent duct-to-mucosa pancreaticojejunostomy at the Affiliated Jinhua Hospital of Zhejiang University School of Medicine from January 2016 to August 2021 were retrospectively analyzed. Of the 93 patients who underwent laparoscopic pancreaticoduodenectomy, there were 48 males and 45 females, with age of (62±10) years old. These patients were divided into two groups: patients who underwent double purse-string and bridging pancreaticojejunostomy (the double purse-string group, n=51), and patients who underwent duct-to-mucosa pancreaticojejunostomy (the duct-to-mucosa group, n=42). The clinical data of the two groups were compared. Results:All the 93 patients underwent laparoscopic pancreaticoduodenectomy successfully, and there were no deaths within 3 months of operation. Compared with the duct-to-mucosa group, the double purse-string group had significantly shorter time of pancreaticojejunal anastomosis [(32.41±8.75) vs. (47.62±8.90) min] and time of operation [(365.75±43.74) vs. (389.07±45.31) min] (all P<0.05). The postoperative pancreatic fistula rates were 9.8% (5/51) in the double purse-string group and 7.1% (3/42) in the duct-to-mucosa group. There was no significant difference between the two groups ( P>0.05). In the double purse-string group, there were 18 patients with a pancreatic duct diameter >3 mm, and 3 of these patients developed grade B pancreatic fistula, giving a grade B pancreatic fistula rate of 16.6% (3/18). In the duct-to-mucosa group, there were 11 patients with a pancreatic duct diameter >3 mm, and no patients developed grade B pancreatic fistula, giving a pancreatic fistula rate of 0(0/11). Conclusion:Compared with the duct-to-mucosa anastomosis, the double purse string and bridging pancreaticojejunostomy was technically simpler. It shortened the time of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy, especially for patients with a non-dilated pancreatic duct.
