Postoperative pancreatic fistula (POPF) remains a persistent problem after pancreaticoduodenectomy (PD), especially in the presence of a soft, nonfibrotic pancreas. To reduce the risk of POPF, pancreaticogastrostomy (PG) is an optional reconstruction technique for surgeons after PD. This study presents a new technique of PG for a soft, nonfibrotic pancreas with double-binding continuous hemstitch sutures and evaluates its safety and reliability. From January 2011 to June 2012, 92 cases of patients with periampullary malignancy with a soft pancreas underwent this technique. A modified technique of PG was performed with two continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall, respectively. Then the morbidity and mortality was calculated. This technique was applied in 92 patients after PD all with soft pancreas. The median time for the anastomosis was 12 min (range, 8-24). Operative mortality was zero, and morbidity was 16.3 % (n = 15), including hemorrhage (n = 2), biliary fistula (n = 2), pulmonary infection (n = 1), delayed gastric emptying (DGE; n = 5, 5.4 %), abdominal abscess (n = 3, one caused by PF), and POPF (n = 2, 2.2 %). Two patients developed a pancreatic fistula (one type A and one type B) classified according to the International Study Group on Pancreatic Fistula. The described technique is a simple and safe reconstruction procedure after PD, especially for patients with a soft and fragile pancreas.
基金:
National Natural Science Foundation of China [81071775, 81101621, 81172064, 81001068]; National "Eleventh Five-Year" Scientific and Technological Support Projects [2006BAI02A13-402]; 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,Tongji Med Coll,Affiliated Tongji Hosp,Dept Biliary Pancreat Surg,Wuhan 430030,Hubei Province,Peoples R China
通讯作者:
通讯机构:[1]Huazhong Univ Sci & Technol,Tongji Med Coll,Affiliated Tongji Hosp,Dept Biliary Pancreat Surg,Wuhan 430030,Hubei Province,Peoples R China[*1]Huazhong Univ Sci & Technol,Tongji Med Coll,Affiliated Tongji Hosp,Dept Biliary Pancreat Surg,1095 Jiefang Ave,Wuhan 430030,Hubei Province,Peoples R China
推荐引用方式(GB/T 7714):
Zhu Feng,Wang Min,Wang Xin,et al.Modified Technique of Pancreaticogastrostomy for Soft Pancreas with Two Continuous Hemstitch Sutures: A Single-Center Prospective Study[J].JOURNAL OF GASTROINTESTINAL SURGERY.2013,17(7):1306-1311.doi:10.1007/s11605-013-2183-8.
APA:
Zhu, Feng,Wang, Min,Wang, Xin,Tian, Rui,Shi, Chengjian...&Qin, Renyi.(2013).Modified Technique of Pancreaticogastrostomy for Soft Pancreas with Two Continuous Hemstitch Sutures: A Single-Center Prospective Study.JOURNAL OF GASTROINTESTINAL SURGERY,17,(7)
MLA:
Zhu, Feng,et al."Modified Technique of Pancreaticogastrostomy for Soft Pancreas with Two Continuous Hemstitch Sutures: A Single-Center Prospective Study".JOURNAL OF GASTROINTESTINAL SURGERY 17..7(2013):1306-1311