Clinical application of duct-to-mucosa anastomosis technique for pancreaticoduodenectomy

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Author:
ZHANG Shun(Department of Hepato-biliary Surgery,Affiliated Hospital,Medical School,Qingdao Universit,Qingdao 266003,China)
ZHANG Bin(Department of Hepato-biliary Surgery,Affiliated Hospital,Medical School,Qingdao Universit,Qingdao 266003,China)
GUO Wei-dong(Department of Hepato-biliary Surgery,Affiliated Hospital,Medical School,Qingdao Universit,Qingdao 266003,China)
QIU Fa-bo(Department of Hepato-biliary Surgery,Affiliated Hospital,Medical School,Qingdao Universit,Qingdao 266003,China)
WU Li-qun(Department of Hepato-biliary Surgery,Affiliated Hospital,Medical School,Qingdao Universit,Qingdao 266003,China)
Journal Title:
CHINESE JOURNAL OF PANCREATOLOGY
Issue:
Volume 9, Issue 05, 2009
DOI:
10.3760/cma.j.issn.1674-1935.2009.05.004
Key Word:
Digestive system surgical procedures; Pancreaticoduodenectomy; Postoperative complications; Pancreaticojejunostomy

Abstract: Objective To investigate the effect and safety of duct-to-mucosa anastomosis technique for pancreaticoduodenectomy(PD).Methods The clinical data,including pancreatic fistula and other complications,of 189 patients underwent PD with end-to-side pancreaticojejunostomy at our institution from Jan 2001 to Jan 2009 were analyzed retrospectively.The definition of pancreatic fistula was threefold increase over the serum amylase level 7 days after operation,and draining volume was more than 50 ml per day.Results Totally 177 Whipple procedures were performed,while 12 pylorus-preserving pancreateduodenectomy procedures were performed.Five patients developed pancreatic fistula with a incidence of 2.65%(5/189).In which 3 were mild Cases,who fully recovered after conservative management,and the other 2 cages were cured by surgical intervention.Other complications included 9 cases of wound infection(4.76%,9/189),11 cases of empty dysfunction(5.82%,11/189),5 Cases of delayed hemorrhage(2.65%,5/189),and 4 cases of intra-abdominal infection(2.12%,4/189),and 2 patients died due to severe intra-abdominal infection and acute pulmonary infarction.Conclusions Duet-to-mucesa anastomosis technique resembles physiological state with low incidence of pancreatic fistula and delayed anastomosis hemorrhage.It may be used for different kinds of anastomosis for pancreatic stump.

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