Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
World J Surg Oncol. 2018 Mar 27;16(1):68. doi: 10.1186/s12957-018-1365-y.
Pancreatic fistula is a major cause of morbidity and mortality after pancreaticoduodenectomy. The aim of this study is to compare the safety and efficacy of a newly developed technique, namely mesh-reinforced pancreaticojejunostomy, in comparison with the conventional use of pancreaticojejunostomy after undergoing a pancreaticoduodenectomy.
Data was collected from regarding 126 consecutive patients, who underwent the mesh-reinforced pancreaticojejunostomy or conventional pancreaticojejunostomy, after standard pancreaticoduodenectomy by one group of surgeons, between the time period of 2005 and 2016. This data was collected retrospectively. Surgical parameters and perioperative outcomes were compared between these two groups.
A total of 65 patients received mesh-reinforced pancreaticojejunostomy and 61 underwent conventional pancreaticojejunostomy. There were no substantial differences in surgical parameters, mortality, biliary leakage, delayed gastric emptying, gastrojejunostomy leakage, intra-abdominal fluid collection, postpancreatectomy hemorrhage, reoperation, and the total hospital costs between the two groups. Pancreatic fistula rate (15 versus 34%; p = 0.013), overall surgical morbidity (25 versus 43%; p = 0.032), and length of hospital stay (18 ± 9 versus 23 ± 12 days; p = 0.016) were significantly reduced after mesh-reinforced pancreaticojejunostomy. Multivariate analysis of the postoperative pancreatic fistula revealed that the independent factors that were highly associated with pancreatic fistula were a soft pancreatic texture and the type of conventional pancreaticojejunostomy.
This retrospective single-center study showed that mesh-reinforced pancreaticojejunostomy appears to be a safe technique for pancreaticojejunostomy. It may reduce pancreatic fistula rate and surgical complications after pancreaticoduodenectomy.
This research is waivered from trial registration because it is a retrospective analysis of medical records.
胰瘘是胰十二指肠切除术后发病率和死亡率的主要原因。本研究旨在比较一种新开发的技术（即网片加强胰肠吻合术）与传统胰肠吻合术在胰十二指肠切除术后的安全性和疗效。
收集了一组外科医生在 2005 年至 2016 年期间对 126 例连续接受标准胰十二指肠切除术后行网片加强胰肠吻合术或传统胰肠吻合术的患者的数据。这些数据是回顾性收集的。比较两组之间的手术参数和围手术期结果。
共有 65 例患者接受网片加强胰肠吻合术，61 例患者接受传统胰肠吻合术。两组在手术参数、死亡率、胆漏、胃排空延迟、胃肠吻合口漏、腹腔积液、胰十二指肠切除术后出血、再次手术和总住院费用方面无显著差异。胰瘘发生率（15%比 34%；p=0.013）、总手术发病率（25%比 43%；p=0.032）和住院时间（18±9 比 23±12 天；p=0.016）明显降低。多因素分析显示，术后胰瘘的独立相关因素是胰腺质地柔软和传统胰肠吻合术的类型。
这项回顾性单中心研究表明，网片加强胰肠吻合术似乎是一种安全的胰肠吻合术技术。它可能会降低胰十二指肠切除术后胰瘘的发生率和手术并发症。
由于这是对病历的回顾性分析，因此本研究免于试验注册。
