Prevention Of Complication After Pancreaticoduodenetomy By Applying External Drainage Of Pancreatic Fluid And Enteral Nutrition

Objective Pancreaticoduodenectomy (PD) is still the major therapeutic method of periampullary tumor and carcinoma of head of pancreas. But the complication's incidence after PD was up to 30%-40%. Pancreatic fistula and hemorrhage were the most important complications, which were the main reason of high Postoperative death after PD. How to reduce the rate of complication was the major program needed to solve. Many scholars tried to make some improvements in PD, such as Pylorus-preserving pancreaticoduodenectomy, partial or total pancreatectomy, egional pancreatectomy, extended lymphadenectomy and anastomosis, and the cut of mesentery blood vessel, et al. The complications after PD, such as pancreatic fistula, markedly decreased, especially by the improvement of pancreaticojejunostomy methods, using of external drainage of pancreatic fluid, and applying of enteral nutrition. This study is to investigate whether external drainage of pancreatic fluid and enteral nutrition are worth to apply and generalize by analyzing retrospectively the cases of pancreaticoduodenectomy in past nine years. Methods There were 101 patients who underwent pancreaticoduodenectomy in past nine years, with Child's operation. 46 patients used external drainage of pancreatic fluid and enteral nutrition, 32 patients used external drainage of pancreatic fluid but no enteral nutrition, 23 patients neither used drainage of pancreatic fluid nor enteral nutrition. Results 7 patients suffered from complication in 46 patients who used both external drainage of pancreatic fluid and enteral nutrition, pancreatic fistula 1, biliary fistula 2, hemorrhea 1(death), gastroplegia 1, disruption of wound 1, pulmonary infection 1; 6 patients suffered from complication in 32 patients who used external drainage of pancreatic fluid without enteral nutrition, pancreatic fistula 2, biliary fistula 4; 10 patients suffered from complication in 23 patients who hadn't used external drainage of pancreatic fluid and enteral nutrition, pancreatic fistula 4, biliary fistula 4, death 2. Conclusions Application of external drainage of pancreatic could effectively prevent the complication after pancreaticoduodenectomy, and could perform together with Child's operation, which is worth to generalize; enteral nutrition wasn't important in prevention of complication after panceaticoduodenectomy, but it had several fortes, such as lower cost, easy management, and it was worth to apply.