Application of continuous lamellar pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy
10.3760/cma.j.cn113884-20241205-00367
- VernacularTitle:连续板层胰肠吻合在腹腔镜下胰十二指肠切除术中的应用
- Author:
Yongnian REN
1
;
Changqian TANG
;
Xingbo WEI
;
Dongxiao LI
;
Liancai WANG
;
Deyu LI
Author Information
1. 郑州大学人民医院肝胆胰外科，郑州 450003
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Pancreaticoduodenectomy;
Digestive tract reconstruction;
Pancreaticojejunostomy;
Postoperative pancreatic fistula
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(4):273-277
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and feasibility of continuous lamellar pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD).Methods:Clinical data of 313 patients with periampullary tumors undergoing LPD at the People's Hospital of Zhengzhou University from January 2017 to December 2021 were retrospectively analyzed, including 163 males and 150 females, aged (62.5±6.7) years. Patients were divided into two groups according to the type of pancreaticojejunostomy. Patients undergoing continuous lamellar pancreaticojejunostomy were included in the study group ( n=162) and those undergoing traditional pancreaticojejunostomy were included in the control group ( n=151). Clinical data such as gender, age, level of carbohydrate antigen 199 (CA199), operation time, postoperative hospital stay, and complications were collected. In order to reduce the baseline differences between groups, propensity score matching (PSM) was used. Results:There were significant differences in age and preoperative CA199 between the study group and the control group before PSM (all P<0.05). After PSM for age and CA199, 156 cases were successfully matched, with 78 cases in both the study and control group. Preoperative data were conparable between the two groups after PSM (all P>0.05). The drainage time [16.0 (14.0, 21.0)d vs. 18.0(15.8, 22.0)d] and postoperative hospital stay [20.0(15.0, 24.0)d vs. 21.5(20.0, 25.0)d] were shorter in the study group (all P<0.05). The incidence of grade B/C postoperative pancreatic fistula (POPF) in the study group was lower than that in the control group [7.7%(6/78) vs. 20.5%(16/78), P<0.05]. Conclusion:Compared with traditional pancreaticojejunostomy, continuous lamellar pancreaticojejunostomy could be safe and feasible, which might reduce the incidence of grade B/C POPF and enhance postoperative recovery.
