Application of mechanical principles in pancreaticoduodenectomy: "1-tube, 2-needle, 3-suture" pancreaticojejunostomy (with video)
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Department of General Surgery, Sir Run-Run Shaw Hospital, Zhejiang University, Hangzhou 310016, China

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    Abstract:

    The pancreatojejunostomy is one of the most challenging steps in pancreatic reconstruction surgery, and its success directly impacts the patient's prognosis. The pancreas has characteristics such as being narrow at the top and wide at the bottom, fragile in texture, rich in digestive enzymes, and subject to constant intestinal peristalsis. These factors can easily lead to the loosening of the pancreatojejunostomy site and the occurrence of postoperative pancreatic fistula. Through mechanical modeling analysis and a summary of clinical practice, the authors propose a pancreatojejunostomy method based on mechanical principles. This method is summarized as "1-tube, 2-needle, 3-suture" method, which refers to one pancreatic duct stent tube, two types and two strands of different sutures, and three different suturing techniques. This article will provide a detailed introduction to this operative method and deeply analyze its technical principles. Additionally, a retrospective analysis of cases from the authors' center found that this method can effectively reduce the incidence of postoperative pancreatic fistula.

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ZHANG Jinming, SHA Hongcun, CHEN Mingyu. Application of mechanical principles in pancreaticoduodenectomy: "1-tube, 2-needle, 3-suture" pancreaticojejunostomy (with video)[J]. Chin J Gen Surg,2024,33(9):1422-1429.
DOI:10.7659/j. issn.1005-6947.2024.09.009

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History
  • Received:July 09,2024
  • Revised:August 25,2024
  • Adopted:
  • Online: October 12,2024
  • Published: