Clnical Analysis Of Pancreatic Fistula Of Pancreatoduodenectomy

Objective: To evaluate the possible difference pancreatic leakage relative to pancreatic fistula and to analyse the causes of pancreatic fistula and study the measures of prevention and treatment of pancreatic fistula.Methods:One hundred ten patients receiving pancreaticoduodenctomy in our hospital between January 2000 and July 2008 were reviewed seventy-four cases were performed pancreatico-jejunal end-to-end anastomosis,thirty-six cases were performed pancreatico-jejunal end-to-side anastomosis. according to the different ways of Pancreaticojejunostomy andthe different time::comparison the incidence of pancreatic fistula between the two groups.Results:Postoperative complications occurred in 26 cases, the incidence rate was 23.6%, two cases of death, mortality was 1.8%.pancreatic fistula occurred in 4 ases,the incidence rate was 3.6%. the incidence rate of pancreatico-jejunal end-to-end astomosis was 2.3%, the incidence rate of pancreatico-jejunal end-to-side astomosis was 5.6%. the results showde that there were no significant difference of pancreatic fistula among the two groups. before 2004 the incidence rate of pancreatic fistula was 9.7%,after 2004 the incidence rate of pancreatic fistula was1.3%, there were ignificant difference of pancreatic fistula among the two groups.Conclusions: Intraoperative technical factors and some positive measures were visible relatived to pancreatic fistula.the optinal pancreat ojejunal anastomtic technique that accorded to the pancreatic duct size,texture of the remnant pancreas,the specific circumstances of intestine and the experience and technical of surgery,improvement of suture technique,external drainage of pancreatic juice,application of somatost- atin,early enteral nu- trition these can be reduced the incidence of pancr- eatic fistula.