Application of the " two-stitch" fashion in laparoscopic pancreaticojejunostomy for patients with fine pancreatic duct
10.3760/cma.j.cn113884-20240816-00248
- VernacularTitle:"二针法"在腹腔镜手术纤细胰管对空肠吻合中的应用
- Author:
Cang LI
1
;
Xiaokang WU
1
;
Weijian HU
1
;
Xuemin LI
1
;
Haihua ZHOU
1
;
Hengdan FAN
1
;
Shian YU
1
Author Information
1. 浙江大学医学院附属金华医院肝胆胰外科，金华 321000
- Publication Type:Journal Article
- Keywords:
Laparoscopes;
Slim pancreatic ducts;
Pancreaticojejunostomy
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(3):193-196
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility of " two-stitch" fashion in laparoscopic pancreaticojejunostomy (PJ) for patients with fine pancreatic duct (<3 mm).Methods:Clinical data of 32 patients with pancreatic duct diameter <3 mm undergoing laparoscopic PJ using the " two-stitch" fashion between Apr 2021 and Jun 2024 were retrospectively analyzed, including 20 males and 12 females, aged (61.2±23.7) years. Among the patients, there were 23 (71.9%) patients of periampullary tumor and 9 (28.1%) of central pancreatic tumor. 23 (71.9%) patients underwent laparoscopic pancreatoduodenectomy (LPD) and nine (28.1%) underwent laparoscopic central pancreatectomy (LCP). All patients underwent the " two-stitch" fashion of laparoscopic PJ (one stitch each on the ventral and dorsal sides of pancreas for duct-to-mucosal anastomosis). The operation time, PJ time, postoperative hospital stay, postoperative complications (pancreatic fistula, gallbladder leakage, abdominal cavity infection, etc) and mortality were recorded.Result:All patients underwent the " two stitch" laparoscopic PJ successfully, 23(71.9%) patients underwent laparoscopic pancreatoduodenectomy (LPD) and nine (28.1%) underwent laparoscopic central pancreatectomy (LCP). The operation time was (279.3±115.8) min, the PJ time was (31.9±12.2) min, and the postoperative hospital stay was (13.4±8.3) d. Grade B pancreatic fistula occurred in six cases (18.8%, four of LPD and two of LCP), delayed gastric emptying in one case of LPD (3.1%), abdominal infection in three cases (9.4%, two of LPD and one of LCP), biliary fistula in two cases (6.3%, LPD). There were no grade C pancreatic fistula. All patients with postoperative complications were managed with conservative treatment.Conclusion:Laparoscopic " two stitch" PJ for patients with fine pancreatic duct (<3 mm) is safe and feasible.
