Study On Pancreatic Fistula After Different Methods Of Pancreatic-intestinal Anastomosis

Objective:The incidence of pancreatic fistula after pancreaticoduodenectomy was compared between binding pancreaticojejunostomy and pancreaticojejunostomy.The clinical experience and applicable conditions of the two kinds of pancreaticojejunostomy were summarized.Methods:The relatively data of patients who underwent pancreaticoduodenectomy of pancreatic cancer from June 2017 to December 2018 in Renmin Hospital of Zhengzhou University were retrospectively analyzed.According to the type of pancreatojejunostomy,Patients were divided into A group(binding pancreaticojejunostomy 56)and B group(conventional pancreatic duct-to-jejunum mucosa anastomosis 74).The operative time,intraoperative blood loss,postoperative pancreatic fistula and postoperative occurrence time of pancreatic fistula were statistically analyzed and compared between the two groups.Results:(1)Intraoperative bleeding volume: the volume of intraoperative bleeding in the group A(309 ±150 m1)was lower than that in the group B(324 ±169 ml),but there was no significant difference between the two groups(p > 0.05).(2)Operative time:the operative time of the group A(279 ±46 min)was shorter than that of the group B(295 ±62 min),but there was no significant difference between the group A and group B(p > 0.05)(3)The average postoperative hospitalization days were(20 ±8)days in the group A and(22 ±11)days in the group B.There was no significant difference between the two groups(p > 0.05).(4)The incidence of postoperative pancreatic fistula was 8.92% in the group A and 9.46% in the group B.There was no significant difference between the two groups(p > 0.05).(5)The texture of pancreas in the group A was hard / soft(29 / 27),while in the group B(45 / 29),P=0.02 < 0.05,and there was a significant difference between the two groups.The diameter of pancreatic duct in group A(2.38 ±0.74)was smaller than that in group B(3.92 ±1.13),the difference was statistically significant.Biochemical fistula、B and C fistula occurred in 7-11 days after operation in both groups.Conclusions:Pancreaticojejunostomy for mucosal anastomosis and Binding anastomosis are the two main methods of pancreaticojejunostomy.They are similar in the incidence and time of postoperative pancreatic fistula,but the application conditions are slightly different,so they can be selected flexibly according to the situation during operation.