Objective:To study the effect of preoperative pancreatic duct stent placement in enucleation (EN) of pancreatic tumor adjacent to the main pancreatic duct (MPD).Methods:Clinical data of 56 patients with benign or borderline pancreatic tumor adjacent to the MPD undergoing EN in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2022 to September 2024 were retrospectively analyzed, including 25 males and 31 females, aged (32.0±5.5) years. Among the patients, 35 (62.5%) were solid pseudopapillary neoplasm, 15 (26.8%) were neuroendocrine tumor, and 6 (10.7%) were serous cystic tumor. According to whether the pancreatic duct stent was placed through encoscopic retrograde cholangiopancreatography preoperatively, patients were divided into the stent group ( n=20, observation group) and no-stent group ( n=36, control group). The operation time, intraoperative pancreatic duct injury, tumor enucleation time and blood loss, grade B/C pancreatic fistula and postoperative hospital stay were compared between the two groups. Results:All patients underwent EN successfully. The operation time in the observation group was shorter than that in the control group [150.0 (143.5, 159.0) vs 158.0 (150.0, 180.0) min, Z=-2.08, P=0.031], and the rate of intraoperative MPD injury in the observation group was lower than that in the control group [10.0% (2/20) vs 38.9% (14/36), χ2=5.26, P=0.022]. The tumor enucleation time and blood loss were comparable between the two groups (both P>0.05). The rate of postoperative grade B/C pancreatic fistula in the observation group was lower than that in the control group [15.0% (3/20) vs 41.7% (15/36), χ2=4.19, P=0.041], and the postoperative hospital stay was also shorter in the observation group [(7.9±1.6) vs (9.3±2.1) d, t=-2.57, P=0.014]. Conclusion:Under the premise of matured endoscopic operation, preoperative pancreatic duct stent placement through ERCP in the EN of pancreatic tumor adjacent to the MPD can protect the MPD during operation, reduce the occurrence of postoperative grade B/C pancreatic fistula, and shorten the postoperative hospital stay.

Objective:To study the effect of preoperative pancreatic duct stent placement in enucleation (EN) of pancreatic tumor adjacent to the main pancreatic duct (MPD).Methods:Clinical data of 56 patients with benign or borderline pancreatic tumor adjacent to the MPD undergoing EN in the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2022 to September 2024 were retrospectively analyzed, including 25 males and 31 females, aged (32.0±5.5) years. Among the patients, 35 (62.5%) were solid pseudopapillary neoplasm, 15 (26.8%) were neuroendocrine tumor, and 6 (10.7%) were serous cystic tumor. According to whether the pancreatic duct stent was placed through encoscopic retrograde cholangiopancreatography preoperatively, patients were divided into the stent group ( n=20, observation group) and no-stent group ( n=36, control group). The operation time, intraoperative pancreatic duct injury, tumor enucleation time and blood loss, grade B/C pancreatic fistula and postoperative hospital stay were compared between the two groups. Results:All patients underwent EN successfully. The operation time in the observation group was shorter than that in the control group [150.0 (143.5, 159.0) vs 158.0 (150.0, 180.0) min, Z=-2.08, P=0.031], and the rate of intraoperative MPD injury in the observation group was lower than that in the control group [10.0% (2/20) vs 38.9% (14/36), χ2=5.26, P=0.022]. The tumor enucleation time and blood loss were comparable between the two groups (both P>0.05). The rate of postoperative grade B/C pancreatic fistula in the observation group was lower than that in the control group [15.0% (3/20) vs 41.7% (15/36), χ2=4.19, P=0.041], and the postoperative hospital stay was also shorter in the observation group [(7.9±1.6) vs (9.3±2.1) d, t=-2.57, P=0.014]. Conclusion:Under the premise of matured endoscopic operation, preoperative pancreatic duct stent placement through ERCP in the EN of pancreatic tumor adjacent to the MPD can protect the MPD during operation, reduce the occurrence of postoperative grade B/C pancreatic fistula, and shorten the postoperative hospital stay.

Objective:To investigate the influencing factors of prolonged postoperative ileus (PPOI) in patients undergoing pancreaticoduodenectomy (PD) during hospitalization.Methods:The data of 339 patients underwent PD admitted to the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from January 2018 to September 2023 were retrospectively analyzed, including 204 males and 135 females, aged (60.6±11.2) years. Among the 339 patients, 112 (33.0%) had pancreatic tumors, 94 (27.7%) had Vater ampullary tumors, 82 (24.2%) had common bile duct tumors, and 51 (15.0%) had duodenal tumors. A total of 339 patients with PPOI were included in the PPOI group ( n=43) and those without PPOI were included in the control group ( n=296). The two groups were compared in terms of age, PD operation (open or laparoscopic), gastrojejunostomy (retrocolic or antecolic gastrojejunostomy), grade B or C pancreatic fistula, hypokalemia, and postoperative use of patient-controlled intravenous analgesia (PCIA). The index comparing P<0.05 between the two groups was further included in the multivariate logistic regression analysis to analyze the influencing factors of PPOI in PD patients. Results:There were statistically significant differences in age >70 years, PD operation, gastrojejunostomy, grade B or C pancreatic fistula, hypokalemia, and postoperative use of PCIA between the two groups (all P<0.05). Multivariate logistic regression analysis showed grade B or C pancreatic fistula ( OR=3.17, 95% CI: 1.48-6.82), open surgery ( OR=2.90, 95% CI: 1.35-6.24), retrocolic gastrojejunostomy ( OR=2.47, 95% CI: 1.23-4.95), postoperative usage of PCIA ( OR=2.61, 95% CI: 1.21-5.62), age >70 years ( OR=2.47, 95% CI: 1.71-5.19) had a high risk of PPOI during postoperative hospitalization (all P<0.05). Conclusion:Postoperative grade B or C pancreatic fistula, open surgery, retrocolic gastrojejunostomy (compares with antecolic gastrojejunostomy), postoperative using PCIA, and age >70 years are independent risk factors for PPOI in patients undergoing PD during postoperative hospitalization.

Objective:To summarize the clinical characteristics of patients with unicentric Castleman disease(UCD).Method:The clinical data of 8 abdominal UCD patients who received surgical resection at the Second Hospital of Hebei Medical University from Oct 2019 to Oct 2022 were analyzed, and the imaging characteristics, pathological types and prognosis were summarized.Result:There were 2 males and 6 females. The average age of patients was (33.0±13.7) years old, and their BMI was (23.2±4.5) kg/m 2. The median maximum diameter of the tumor was 4.5 (3.0-4.9) cm. The average postoperative hospital stay was 6.5 (3.3-12.0) days. One was lost during follow up, there was no recurrence or other postoperative complications in the remaining 7 patients. Conclusion:The incidence of unicentric Castleman disease is rare. Complete resection of the tumor is the main treatment for UCD patients, and the prognosis of UCD is good.