Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
Sci Rep. 2013;3:2068. doi: 10.1038/srep02068.
Pancreaticojejunostomy is the key procedure of pancreaticoduodenectomy. Our study introduced a new pancreaticojejunal (PJ) anastomosis named "papillary-like main pancreatic duct invaginated" pancreaticojejunostomy. Nighty-two patients underwent pancreaticojejunostomy with either conventional duct-to-mucosa pancreaticojejunostomy or the new "papillary-like main pancreatic duct invaginated" techniques were analyzed retrospectively from January 2010 to September 2012. The incidence of pancreatic fistula was 15.7% (8/51) for the "papillary-like main pancreatic duct invaginated" group and 19.5% (8/41) for the duct-to-mucosa fashion respectively. It is noteworthy that the rate of grade B/C postoperative pancreatic fistula (POPF) in the "papillary-like main pancreatic duct invaginated" group was significantly lower than that of the duct-to-mucosa group (P = 0.039). There were no differences in the incidence of postoperative morbidity and mortality such as postoperative hemorrhage, delayed gastric emptying or remnant pancreatitis. The "papillary-like main pancreatic duct invaginated" pancreaticojejunostomy could provide a feasible option to pancreatic surgeons for patients with normal soft pancreas.
胰肠吻合术是胰十二指肠切除术的关键步骤。我们介绍了一种新的胰肠吻合术，命名为“乳头样主胰管内陷”胰肠吻合术。回顾性分析了 2010 年 1 月至 2012 年 9 月期间 92 例行胰肠吻合术的患者，其中 51 例行传统的胰管黏膜吻合术，41 例行新的“乳头样主胰管内陷”技术。胰瘘的发生率分别为“乳头样主胰管内陷”组 15.7%（8/51）和胰管黏膜吻合组 19.5%（8/41）。值得注意的是，“乳头样主胰管内陷”组术后 B/C 级胰瘘（POPF）的发生率明显低于胰管黏膜吻合组（P=0.039）。术后出血、胃排空延迟或残胰腺炎等术后并发症和死亡率无差异。对于胰腺质地正常的患者，“乳头样主胰管内陷”胰肠吻合术可为胰腺外科医生提供一种可行的选择。
