Application of Hong′s single-stitch duct to mucosa pancreaticoenterostomy in laparoscopic pancreaticoduodenectomy
10.3760/cma.j.cn115667-20211021-00193
- VernacularTitle:"洪氏一针法"胰管空肠吻合方式在腹腔镜胰十二指肠切除术中的运用
- Author:
Yu FU
1
;
Shupeng WANG
;
Lingyu MENG
;
Yahui LIU
Author Information
1. 吉林大学第一医院肝胆胰外二科，长春 130021
- Keywords:
Pancreatic fistula;
Pancreaticojejunostomy;
Risk factors;
Laparoscopes;
Pancreaticoduodenectomy
- From:
Chinese Journal of Pancreatology
2022;22(3):191-195
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the value of Hong′s single-stitch duct to mucosa pancreaticoenterostomy(HSDMP) in laparoscopic pancreaticoduodenectomy(LPD).Methods:The perioperative clinical data of 300 patients undergoing LPD admitted to the Second Department of Hepatobiliary Surgery in the First Hospital of Jilin University from April 2015 to March 2019 were retrospectively analyzed. The patients were categorized into pancreatic fistula group( n=43) and non pancreatic fistula group( n=257). according to the presence or absence of postoperative pancreatic fistula. Among them, pancreaticojejunostomy was performed with HSDMP in 210 patients, and 90 patients underwent traditional pancreaticoenterostomy. Univariate and multivariate logistic regression were used to analyze the risk factors for the development of pancreatic fistula after LPD, and the difference on the time of pancreaticojejunostomy and the incidence of postoperative pancreatic fistula were compared between HSDMP and traditional pancreaticojejunostomy. Results:Univariate analysis showed that the differences on BMI, abdominal operation history, pancreatic texture, and pancreatic duct diameter were statistically significant compared with non-pancreatic fistula group (all P value <0.05). Multivariate logistic regression showed that BMI ( OR1.180, 95% CI1.047-1.338, P=0.008) and pancreatic texture( OR=0.375, 95% CI 0.135-0.861, P=0.036) were independent risk factors for pancreatic fistula after LPD. Compared with traditional pancreaticojejunostomy, HSDMP was associated with shorter anastomosis time and low incidence of postoperative pancreatic fistula, but there was no statistical significance between the two groups. Conclusions:The independent risk factors for pancreatic fistula are high BMI and soft pancreatic texture. Compared with traditional pancreaticojejunostomy, HSDMP does not prolong LPD time and increase the incidence of postoperative pancreatic fistula.
