Abstract:Objective:To analyze the causes, prevention, and treatment of postoperative complications of pancreaticoduodenectomy(PD).
Methods :A retrospective review of 154 consecutive patients who underwent PD with pancreaticojejunostomy in recent 5 years was carried out.In 105 cases, a single-layer invaginated pancreaticojejunostomy was used, and in 49 cases a double-layer invaginated pancreaticojejunostomy was used.
Results:The total complication rate after PD was 22.7 %. The surgery-related complication rate was 18.1 %（19 of 105)in single-layer anastomosis group, while it was 32.7 %(16 of 49,P=0.045) in the double-layer anastomosis group. The pancreatic fistula rate in the single-layer group was 4.8 %（5 of 105）and in the double-layer group was 16.4 % (8 of49,P=0.016).The mean length of hospital stay after PD was longer in the double-layer group ［(22.75±9.73） d］ as compared to the single-layer group ［(18.45±7.11） d］ （P=0.002）. Uni-and multivariate analysis showed 3 independent risk factors for pancreatic fistula formation:(1)male gender; (2)soft pancreatic gland;(3)not using a single-layer invaginated pancreaticojejunostomy.
Conclusions:The appropriate type of pancreaticojejunostomy and perioperative treatment can effectively decrease postoperative complications after PD.