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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2020, Vol. 14 ›› Issue (03): 264-267. doi: 10.3877/cma.j.issn.1674-3946.2020.03.015

Special Issue:

• Original Article • Previous Articles     Next Articles

Clinical application of modified end-to-side anastomosis of pancreatic duct and jejunal mucosa in PD

Yaobing Luo1, Xiaoli Xu2,()   

  1. 1. Emergency surgery Department, famous Hospital of Enshi Tujia and Miao Autonomous Prefecture, Hubei Province, Enshi 445000, Hubei
    2. First Aid Center of famous nationality Hospital of Enshi Tujia and Miao Autonomous prefectures, Hubei Province, Enshi 445000, Hubei
  • Received:2019-10-11 Online:2020-06-26 Published:2020-06-26
  • Contact: Xiaoli Xu
  • About author:
    Corresponding author: Xu Xiaoli, Email:
  • Supported by:
    Hubei Health and Planning Commission Fund Project(WJ2017H551)

Abstract:

Objective

To investigate the effect of modified end-to-side anastomosis of pancreatic duct and jejunal mucosa in pancreatoduodenectomy.

Methods

62 patients with pancreaticoduodenectomy (PD) from January 2016 to March 2019 were retrospectively analyzed, which included 30 patients with modified end-to-side anastomosis of pancreatic duct and jejunal mucosa (modified group) and 32 cases of traditional end-to-side anastomosis of pancreatic duct and jejunal mucosa (traditional group). SPSS 20.00 statistical software was used for analysis. The postoperative complications of the two groups, the postoperative complications of pancreatic fistula, and the level of amylase in the abdominal drainage fluid at 1, 3, 5, 7 and 9 days after operation were observed. The complication and other count data were expressed in n%, and compared with Fisher exact probability method or χ2 test, perioperative indicators were expressed as (±s), and compared with t test. P<0.05 was a statistical difference.

Results

The amount of bleeding in the modified group was significantly lower than that in the traditional group (P<0.05). There were no significant differences in the other surgical indexes (P>0.05). In the modified group, 1 case of pancreatic fistula was significantly smaller than 9 cases in the traditional group (P<0.05). The incidence of grade B pancreatic fistula in the modified group was significantly lower than that in the traditional group (P<0.05), and the difference of incidence of biochemical fistula and C-class pancreatic fistula between the two groups was not statistically significant (P>0.05). The contents of amylase in the abdominal drainage fluid of the two groups of patients was less than those in the modified group during the 1, 3, 5, 7, 9 d postoperative detection period.

Conclusion

Compared with the end-to-side anastomosis of pancreatic duct and jejunal mucosa, the modified end-to-side anastomosis of pancreatic duct and jejunal mucosa can effectively reduce the incidence of pancreatic fistula in PD, and has certain clinical promotion value.

Key words: Pancreaticoduodenectomy, Pancreaticojejunostomy, Pancreatic fistula, Drainage, Pancreatic alpha-Amylases

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