"San Matteo degli Infermi" Hospital, AUSL Umbria 2, Via Loreto, 06049 Spoleto, Italy; University of Perugia, PhD School in Biotechnologies, Italy.
University of Perugia, Department of Surgical and Biomedical Sciences, Via G. Dottori, 06100 Perugia, Italy; "San Giovanni" Bellinzona e Valli Regional Hospital, 6500 Bellinzona, Switzerland.
Int J Surg. 2014;12 Suppl 1:S87-90. doi: 10.1016/j.ijsu.2014.05.046. Epub 2014 May 27.
The pancreatic anastomosis is the most demanding step after pancreaticoduodenectomy (PD) and the pancreatic fistula (PF) is the most dreaded complication. Many techniques have been investigated to assess the best way to deal with the pancreatic stump after PD and none of these has shown to be superior in terms of statistically significant reduction of PF rate. We report the preliminary experience of a new technique of pancreaticojejunostomy (PJ).
Fifteen patients underwent PD for neoplasms with end-to-side PJ with dunking jejunal "J"-loop, between July 2011 and March 2014. The data about their post-operative outcomes were analyzed.
There were no intra-operative neither post-operative deaths. One patient had a grade A PF (6.7%). Total post-operative complications occurred in 6 patients (40%), major post-operative complications occurred in 3 patients (20%).
The new "sandwich" technique for dunking PJ after PD that we describe proved to be easy to perform and sure. It appears to be suitable for a dunking PJ when the diameter of the jejunum is too small than this of the pancreatic stump.
胰肠吻合是胰十二指肠切除术（PD）后最具挑战性的步骤，胰瘘（PF）是最令人恐惧的并发症。已经研究了许多技术来评估 PD 后处理胰头残端的最佳方法，但没有一种方法在降低 PF 发生率方面显示出统计学上的优势。我们报告一种新的胰肠吻合（PJ）技术的初步经验。
2011 年 7 月至 2014 年 3 月，15 例肿瘤患者接受了 PD 治疗，采用端侧 PJ 与浸泡式空肠“J”形袢，分析了他们的术后结果数据。
无术中或术后死亡。1 例患者发生 A 级 PF（6.7%）。6 例患者发生总术后并发症（40%），3 例患者发生重大术后并发症（20%）。
我们描述的 PD 后浸泡式 PJ 的新“三明治”技术易于操作且安全。当空肠直径比胰头残端小时，这种技术似乎适用于浸泡式 PJ。
