Antila Anne, Sand Juhani, Nordback Isto, Räty Sari, Laukkarinen Johanna
Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Teiskontie 35, P.O. Box 2000, 33521 Tampere, Finland.
Biomed Res Int. 2014;2014:508714. doi: 10.1155/2014/508714. Epub 2014 Jun 11.
After pancreaticoduodenectomy, the Finnish binding pancreaticojejunal anastomosis (FBPJ) seems to reduce the risk for pancreatic fistula (POPF). Our aim was to investigate whether FBPJ is feasible and prevents the risk for POPF even after left pancreatectomy (LP).
47 consecutive patients underwent LP. 27 patients were recruited on the basis of CT and, of these, 16 patients were randomized on the basis of findings during surgery (transection line must be left of portal vein, as 2-3 cm pancreatic mobilization is required for FBPJ) to receive either Roux-Y FBPJ or hand-sewn closure of the pancreatic remnant.
Only 34% (16/47) of the patients met the randomization criteria. Clinically significant POPF rate was higher in FBPJ group (60%) compared to thand-sewn closure group (13%; P<0.05). POPF rate in FBPJ group was higher even when compared to all patients with hand-sewn closure (60% versus 37%; P<0.05). Overall, FBPJ was technically feasible for only 28% of patients.
FBPJ cannot be recommended for the routine closure of the pancreatic remnant after LP, as it was not technically achievable in 72% of the cases. Moreover, the technique does not seem to reduce the risk for POPF compared to the hand-sewn closure.
胰十二指肠切除术后，芬兰捆绑式胰空肠吻合术（FBPJ）似乎可降低胰瘘（POPF）风险。我们的目的是研究FBPJ在胰体尾切除术（LP）后是否可行并预防POPF风险。
47例连续患者接受了LP。27例患者根据CT结果入选，其中16例患者根据手术中的发现（横断线必须在门静脉左侧，因为FBPJ需要2 - 3厘米的胰腺游离）随机分为接受Roux - Y FBPJ或手工缝合关闭胰腺残端。
仅34%（16/47）的患者符合随机化标准。FBPJ组临床显著POPF发生率（60%）高于手工缝合关闭组（13%；P<0.05）。与所有接受手工缝合关闭的患者相比，FBPJ组的POPF发生率也更高（60%对37%；P<0.05）。总体而言，FBPJ仅对28%的患者在技术上可行。
不推荐将FBPJ用于LP后胰腺残端的常规关闭，因为72%的病例在技术上无法实现。此外，与手工缝合关闭相比，该技术似乎并未降低POPF风险。
