Zou Jiayue, Sun Ding, Zhang Weigang, Wang Daobin, Shen Danyang, Qin Lei, Xue Xiaofeng
Department of Hepatobiliary and Pancreatic Surgery, Department of General Surgery, The First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou, 215006, Jiangsu Province, China.
Pancreatology. 2024 Dec;24(8):1355-1359. doi: 10.1016/j.pan.2024.10.013. Epub 2024 Nov 5.
This study compared the incidence of postoperative pancreatic fistula (POPF) between standard invagination pancreaticojejunostomy (PJ) and an improved PJ technique after pancreaticoduodenectomy and evaluated the clinical utility of the improved PJ procedure.
Clinical and postoperative data of 363 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Soochow University from February 2018 to October 2021 were analyzed retrospectively. In our cohort, 155 patients underwent the improved PJ technique (group A), and 208 underwent standard invagination PJ (group B). Data on demographic characteristics, pathological nature, intraoperative factors, and postoperative complications, including POPF, were collected and analyzed.
There were no significant between-group differences in demographic characteristics (p > 0.05). The improved PJ technique was associated with a significantly lower incidence of clinically relevant POPF (CR-POPF) in the total cohort (11.6 % vs. 26.4 %, p < 0.001) and in the subgroup with high fistula risk scores (16.0 % vs. 38.6 %, p < 0.001).
The improved invagination PJ technique reduces the incidence of CR-POPF and improves prognosis.
本研究比较了标准套入式胰肠吻合术（PJ）与改良PJ技术在胰十二指肠切除术后胰瘘（POPF）的发生率，并评估改良PJ手术的临床应用价值。
回顾性分析2018年2月至2021年10月在苏州大学附属第一医院接受胰十二指肠切除术的363例患者的临床和术后资料。在我们的队列中，155例患者接受了改良PJ技术（A组），208例接受了标准套入式PJ（B组）。收集并分析了人口统计学特征、病理性质、术中因素和术后并发症（包括POPF）的数据。
两组患者在人口统计学特征方面无显著差异（p>0.05）。改良PJ技术与整个队列中临床相关POPF（CR-POPF）的发生率显著降低相关（11.6%对26.4%，p<0.001），在瘘风险评分高的亚组中也是如此（16.0%对38.6%，p<0.001）。
改良套入式PJ技术降低了CR-POPF的发生率，改善了预后。
