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Imbedding pancreaticojejunostomy used in pure laparoscopic pancreaticoduodenectomy for nondilated pancreatic duct

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单位: [1]Huazhong Univ Sci & Technol,Affiliated Tongji Hosp,Dept Biliary Pancreat Surg,Tongji Med Coll,1095 Jiefang Ave,Wuhan 430030,Hubei,Peoples R China [2]Huazhong Univ Sci & Technol,Affiliated Tongji Hosp,Dept Endocrinol,Tongji Med Coll,Wuhan 430030,Peoples R China [3]Zhejiang Univ, Sch Med, Affiliated Hosp 2, Dept Gen Surg, 88 Jiefang Rd, Hangzhou 310016, Zhejiang, Peoples R China
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关键词: Laparoscopic pancreaticoduodenectomy Pancreaticojejunostomy Postoperative pancreatic fistula

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Backround LPD has been cautiously regarded as feasible and safe for resection and reconstruction. However, anastomosis of the remnant pancreas is still thought to be a critical obstacle to the dissemination of LPD in general practice. This study presents a new technique of pancreaticojejunostomy for nondilated pancreatic duct and evaluates its safety and reliability. Methods From July 2014 to June 2015, a total of 52 patients underwent LPD with the new technique. A modified technique of duct-to-mucosa PJ was performed with transpancreatic interlocking mattress sutures, named the imbedding duct-to-mucosa PJ. Then the morbidity and mortality was calculated. Results This technique was applied in 52 patients after LPD all with nondilated pancreatic duct (1-3 mm). The mean operation time was 4.6 h (range, 3.5-8.3 h) and the median time for the anastomosis was 37 min (range, 24-53 min). Operative mortality was zero, and morbidity was 21.2 % (n = 11), including hemorrhage (n = 3, 5.8 %), biliary fistula (n = 1, 1.9 %), pulmonary infection (n = 1, 1.9 %), delayed gastric emptying (n = 2, 3.8 %), abdominal abscess caused by biliary fistula or PF formation (n = 2, 3.8 %), and POPF (n = 2, 3.8 %). Two patients developed a pancreatic fistula (one type A, one type B) classified according to the International Study Group on Pancreatic Fistula. Conclusions The described technique is a simple and safe reconstruction procedure after LPD, especially for patients with nondilated pancreatic duct.

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出版当年[2016]版:
大类 | 2 区 医学
小类 | 2 区 外科
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大类 | 2 区 医学
小类 | 2 区 外科
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Q1 SURGERY
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Q1 SURGERY

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第一作者单位: [1]Huazhong Univ Sci & Technol,Affiliated Tongji Hosp,Dept Biliary Pancreat Surg,Tongji Med Coll,1095 Jiefang Ave,Wuhan 430030,Hubei,Peoples R China
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