General Surgery Department, The First Affiliated Hospital to Henan University of Science and Technology, 24 Jinghua Road, Luoyang, China.
Medicine (Baltimore). 2021 Dec 10;100(49):e27834. doi: 10.1097/MD.0000000000027834.
Postoperative pancreatic leakage is an obstacle in pancreaticoduodenectomy, which always follows pancreaticojejunostomy (PJ) failure. Dozens of PJ procedures have been reported, and none have shown superiority over others. Therefore, the present study is conducted to assess the potential advantages of invaginated duct-to-mucosa (D-M) PJ.We retrospectively analyze the related data from patients who underwent pancreaticodedunostomy due to malignant tumors at the First Affiliated Hospital of Henan University of Science and Technology from January 2017 to August 2019. According to the different PJ procedures, the patients are divided into custom D-M group and invaginated D-M group. Matching by sex, age, pancreatic duct size, and pancreatic texture is performed. Pancreatic leakage and other complications are compared, and SPSS 16.0 is employed for analysis.A total of 48 pairs of patients are included. Patients in both groups has almost the same baseline characteristics in terms of sex (P = 1.000), age (P = .897), American Society of Anesthesiologists status (P = .575), body mass index (P = .873), pancreatic duct size (P = .932), pancreatic texture (P = 1.000) and tumor origin (P = .686). No significant difference is observed in operative outcomes, such as operative duration (P = .632), PJ duration (P = .748), blood loss (P = .617) and number of required transfusions (P = .523). Pancreatic leakage is significantly decreased in the invaginated D-M group (P = .005). The differences in other complications, such as bleeding (P = .617), biliary leakage (P = .646), pneumonia (P = .594) and thrombosis (P = .714), do not reach statistical significance. The postoperative hospitalization duration is almost the same for both groups (P = .764).Invaginated D-M PJ may reduce pancreatic leakage following pancreaticoduodenectomy.
术后胰漏是胰十二指肠切除术的障碍,通常继发于胰肠吻合术(PJ)失败。已经报道了数十种 PJ 手术,但没有一种显示出优于其他手术的优势。因此,本研究旨在评估套入式管-黏膜(D-M)PJ 的潜在优势。
我们回顾性分析了 2017 年 1 月至 2019 年 8 月在河南科技大学第一附属医院因恶性肿瘤行胰十二指肠切除术的患者的相关数据。根据不同的 PJ 手术方式,患者分为常规 D-M 组和套入式 D-M 组。通过性别、年龄、胰管大小和胰腺质地进行匹配。比较胰漏等并发症,采用 SPSS 16.0 进行分析。
共纳入 48 对患者。两组患者在性别(P=1.000)、年龄(P=0.897)、美国麻醉医师协会状态(P=0.575)、体重指数(P=0.873)、胰管大小(P=0.932)、胰腺质地(P=1.000)和肿瘤起源(P=0.686)方面具有几乎相同的基线特征。手术结果无显著差异,如手术时间(P=0.632)、PJ 时间(P=0.748)、出血量(P=0.617)和所需输血次数(P=0.523)。套入式 D-M 组胰漏明显减少(P=0.005)。其他并发症如出血(P=0.617)、胆漏(P=0.646)、肺炎(P=0.594)和血栓形成(P=0.714)的差异无统计学意义。两组术后住院时间几乎相同(P=0.764)。
套入式 D-M PJ 可能减少胰十二指肠切除术后胰漏的发生。