Clinical application of parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy
10.3760/cma.j.issn.1007-8118.2019.06.008
- VernacularTitle:降落伞式双荷包胰管空肠吻合在腹腔镜胰十二指肠切除术中的临床应用
- Author:
Jiansheng ZHANG
1
;
Dongrui LI
;
Jianhua LIU
;
Zhongqiang XING
;
Tianyang WANG
;
Chengxu DU
;
Wenyan LU
Author Information
1. 河北医科大学第二医院肝胆外科
- Keywords:
Pancreaticoduodenectomy;
Laparoscopes;
Double-pouch pancreaticojejunostomy;
Parachute-like suture;
Pancreatic fistula
- From:
Chinese Journal of Hepatobiliary Surgery
2019;25(6):431-434
- CountryChina
- Language:Chinese
-
Abstract:
Objective To introduce the detailed surgical procedure of parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy (LPD),and to study its clinical results.Methods A retrospective study was conducted on 31 patients who underwent parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy between January 2016 and June 2018 in our department.Results Of 31 patients who underwent total laparoscopic pancreaticoduodenectomy,5 patients underwent two-dimensional (2D) LPD and 26 underwent three-dimensional (3D) LPD.Total mesopancreas excision (TMpE) was performed in 12 patients,including 2 patients combined with PV-SMV segmental resection and reconstruction.The mean operative duration,and mean estimated blood loss,post-operative hospital stay were 412.8 ± 102.4 min,462.8 ± 396.7 ml,14.7 ± 8.9 d,respectively.The operating time of parachute-like-suture double-pouch pancreaticojejunostomy was 29.7 ± 6.8 min (20 ～45 min).Post-operative complications occurred in 8 patients (25.8％),3 of whom suffered from more than two types of complications.There were 2 patients (6.5％) with postoperative B/C grade pancreatic fistula,4 patients with postoperative biliary leakage (12.9％),3 patients with delayed gastric emptying (9.7％),1 patient with portal vein thrombosis (3.2％) and 1 patient with peritoneal effusion (3.2％).One patient died during perioperative period due to gastrointestinal hemorrhage.Conclusions Parachute-like-suture double-pouch pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy was a simple,convenient,reliable method.It is worthy of clinical promotion and further studied.
