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.
基金:
The National Natural Science Foundation of China [81071775, 81272659, 81101621, 81172064, 81001068, 81272425, 81372353]; Key Projects of Science Foundation of Hubei Province [2011CDA030]; Research Fund of Young Scholars for the Doctoral Program of Higher Education of China [20110142120014]
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
通讯作者:
推荐引用方式(GB/T 7714):
Wang Min,Xu Simiao,Zhang Hang,et al.Imbedding pancreaticojejunostomy used in pure laparoscopic pancreaticoduodenectomy for nondilated pancreatic duct[J].SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES.2017,31(4):1986-1992.doi:10.1007/s00464-016-4805-1.
APA:
Wang, Min,Xu, Simiao,Zhang, Hang,Peng, Shuyou,Zhu, Feng&Qin, Renyi.(2017).Imbedding pancreaticojejunostomy used in pure laparoscopic pancreaticoduodenectomy for nondilated pancreatic duct.SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES,31,(4)
MLA:
Wang, Min,et al."Imbedding pancreaticojejunostomy used in pure laparoscopic pancreaticoduodenectomy for nondilated pancreatic duct".SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES 31..4(2017):1986-1992