Analysis Of Postoperative Complications Of Pancreaticoduodenectomy With Different Mothods

Objective:Pancreaticoduodenectomy(PD)is one of the most difficult operations in the department of hepatobiliary and pancreatic surgery.The postoperative outcomes,such as pancreatic fistula,hemorrhage,biliary fistula,abdominal infection are often catastrophic.Therefore,since the creation of the surgery,the chirurgeon has been exploring how to improve the surgical approach,especially the way of pancreaticojejunostomy to prevent the occurrence of complications.In our paper,118 cases of pancreaticoduodenectomy were retrospectively analyzed to compare the effects of different Pancreaticojejunostomy on postoperative complications.Method:118 patients were underwent pancreaticoduodenectomy in the First Hospital of Jilin University,Department of Hepatobiliary and Pancreatic Surgery from January 2010 to July 2016.Mucosal group,end-side mucosa-mucosa anastomosis 、 End-side group,end-side invaginated pancreaticojejunostomy 、 End-end group,end-end invaginated pancreaticojejunostomy、Binding group,binding pancreaticojejunostomy.The preoperative factors,intraoperative factors and postoperative factors were analyzed statistically,and the related risk factors of pancreatic fistula were further explored.Result:There was no significant difference in postoperative complications between among all kinds of anastomosis(P> 0.05).Compared with the other three groups,the longest operation time(5.86±1.18h)and the maximum intraoperative blood loss(538.57±392.22ml)is in the mucosal group.The independent risk factors for pancreatic fistula are pancreatic duct diameter,sex,and pancreatic texture.Conclusion:There was no significant difference in the incidence of postoperative complications between different anastomoses.More depends on(It depends mostly on)the skill of the surgeon and the surgical process of the surgical approach to the comprehensive choice.