Abstract:Objective: To investigate the clinical efficacy of using modified pancreatic duct-to-jejunal mucosa end-to-side anastomosis in pancreaticoduodenectomy (PD).
Methods: The clinical data 80 patients undergoing PD from January 2016 to November 2018 were retrospectively analyzed. Of the patients, 39 cases underwent modified pancreatic duct-to-jejunal mucosa end-to-side anastomosis (modified group) and 41 cases underwent traditional pancreatic duct jejunum end-to-side mucosal anastomosis (traditional group). The main clinical variables and the incidence of postoperative pancreatic fistula and other complications were compared between the two groups.
Results: There were no significant differences in preoperative data between the two groups (all P>0.05). No significant differences were noted in total operative time and time for pancreaticojejunostomy, as well as the incidence of intra-abdominal hemorrhage, lymphatic leakage and delayed gastric emptying between the two groups (all P>0.05). The total incidence of pancreatic fistula in the modified group was significantly lower than that in traditional group [5.12% (2/39) vs. 24.4% (10/41), P<0.05], and in modified group, both cases were biochemical leakage and no B/C pancreatic fistula occurred, while in traditional group, biochemical leakage occurred in 2 cases and B/C pancreatic fistula occurred in 8 cases.
Conclusion: Modified pancreatic duct-to-jejunal mucosa end-to-side anastomosis can significantly reduce the incidence of pancreatic fistula after PD compared to traditional procedure. It has certain application value in clinical practice.