Nanchang University Medical College, Nanchang, China.
Department of Hepatobiliary Surgery, Jiangxi Provincial People's Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, China.
Medicine (Baltimore). 2023 Aug 4;102(31):e34049. doi: 10.1097/MD.0000000000034049.
Laparoscopic pancreaticoduodenectomy (LPD) is a classic surgical method for diseases, such as tumors at the lower end of the common bile duct, pancreatic head, and benign and malignant tumors of the duodenum. Postoperative pancreatic fistula (POPF) is one of the most serious complications of LPD. To reduce the incidence of grade B or C POPF and other complications after LPD, we applied a split pancreatic duct stent combined with the characteristics of internal and external stent drainage. Between September 2020 and September 2022,12 patients underwent placement of the Split pancreatic duct stent during LPD. Data on basic characteristics of patients, surgical related indicators and postoperative POPF incidence were collected and analyzed. The results showed that the average operation time was 294.2 ± 36 minutes, average time for pancreaticojejunostomy was 35.9 ± 4.1 minutes, and average estimated blood loss was 204.2 ± 58.2 mL. Biochemical leakage occurred in 2 patients (16.7%), whereas no grade B or C POPF, 1 case (8.3%) had postoperative bleeding, and no death occurred within 30 days after the operation. Preliminary experience shows that the split pancreatic duct stent can effectively reduce the incidence of complications after LPD, especially grade B or C POPF.
腹腔镜胰十二指肠切除术（LPD）是治疗胆总管下段、胰头、十二指肠良恶性肿瘤等疾病的经典手术方法。术后胰瘘（POPF）是 LPD 最严重的并发症之一。为降低 LPD 后 B 级或 C 级 POPF 等并发症的发生率，我们应用分体式胰管支架结合内外支架引流的特点。2020 年 9 月至 2022 年 9 月，12 例患者在 LPD 中放置分体式胰管支架。收集并分析患者基本特征、手术相关指标和术后 POPF 发生率等数据。结果显示，平均手术时间为 294.2±36 分钟，胰肠吻合时间平均为 35.9±4.1 分钟，估计出血量平均为 204.2±58.2mL。2 例（16.7%）发生生化漏，无 B 级或 C 级 POPF，术后出血 1 例（8.3%），术后 30 天内无死亡。初步经验表明，分体式胰管支架可有效降低 LPD 后并发症的发生率，尤其是 B 级或 C 级 POPF。
