The Application Of End To End Invagination Pancreaticojejunostomy With Discontinuous U Suture In Pancreaticoduodenectomy

ObjectiveTo evaluate the application of end to end invagination pancreaticojejunostomy with discontinuous U suture in pancreaticoduodenectomy.MethodsThe clinical data of 263 patients who received pancreaticoduodenectomy at the Department of Hepatobiliary and Pancreatic Surgery in the Third Hospital of Jilin University from August 2006 to June 2016 were retrospectively analyzed.The patients were divided into two groups(group of end to end invagination pancreaticojejunostomy with discontinuous U suture,176 cases and group of end to side duct-to-mucosa pancreaticojejunostomy,87 cases).The general information between the two groups was with no statistically significant difference(P>0.05).The operating time,the volume of bleeding and blood transfusion,the postoperative drainage and hospital stay and the rate of pancreatic fistula and other complications after pancreaticoduodenectomy were obeserved.The results were analyzed by t test,rank sum test,chi-square test and Fisher exact probability respectively.ResultsThe operating time of the U suture group was(5.64±1.24)h,shorter than(7.02±1.98)h of the duct-to-mucosa group(P<0.05).The bleeding volume of the U suture group during operation was 300.00(400.00)ml,less than 400.00(500.00)ml of the duct-to-mucosa group(P<0.05).The total pancreatic fistula rate of the 263 cases was 7.6%(5.1% of the U suture group and 12.6% of the duct-to-mucosa group).The rates of total and grade B pancreatic fistula between the two groups were evidently different(P<0.05),with the U suture group lower.The other observations between the two groups were with no significant difference.ConclusionThe end to end invagination pancreaticojejunostomy with discontinuous U suture could evidently decrease the pancreatic fistula rate especially some severe fistulas.The U suture is safer,more convenient to operate and wouldn’t add more economic burden to the patients.In a word,the U suture is a new pancreaticojejunostomy method with great value.