The effect of end-to-side pancreaticojejunostomy with pocket insertion on the incidence of pancreatic fis-tula after operation / 中华内分泌外科杂志

ABSTRACT

Objective To investigate the effect of end-to-side pancreaticojejunostomy with pocket-inser-tion on the incidence of pancreatic fistula after pancreaticoduodenectomy. Methods The clinical data of 581 patients undergoing pancreaticoduodenectomy from Dec. 2012 to Sep. 2018 in Cangzhou Central Hospital were retrospectively analyzed, including 327 cases of open pancreaticoduodenectomy(OPD), 175 cases of laparoscopic assisted pancreaticoduodenectomy (LAPD), and 79 cases of total laparoscopic pancreaticoduodenectomy. End-to-side pancreaticojejunostomy with pocket-insertion was used in all cases. The incidence of pancreatic fistula after operation was analyzed. Results The overall incidence of grade B or C pancreatic fistula was 3.10％ (18/581) after end-to-side pancreaticojejunostomy with purse-pocket insertion. The incidence of grade B or C pancreatic fistula in OPD group was 2.75％(9/327). The incidence of grade B or C pancreatic fistula in LAPD group was 2.29％ (4/175). The incidence of grade B or C pancreatic fistula in TLPD group was 6.33％ (5/79). The three groups were divided into two subgroups according to the pancreatic texture. There was significant difference in pancreatic duct diameter between subgroups(P<0.05), but there was no significant difference in the time of pan-creaticojejunostomy and the incidence of pancreatic fistula after operation (P>0.05). Conclusion End-to-side pan-creaticojejunostomy with pocket insertion has the advantages of simple operation, strong adaptability, safety and high efficiency, and can control the incidence of pancreatic fistula after pancreaticoduodenectomy at an ideal level.