The Comparative Studies Of The Two Kinds Of Pancreatic Bowel Anastomosis In Pancreatoduo Denectomy (Attach 105 Cases Analysis)

Objective:To analysis the risk factors of early complications after pancreaticoduodenectomy(PD) and to compare the infulence of different ways of pancreaticojejunastomy to the pancreatic leakage and bleeding.Method: Total 105 patients receiving pancreaticoduodenectomy with Child Reconstruction of digestive tract in our hospital between 2001 and 2010 were reviewed,of which 25 patients received end-to-end invagination pancreaticojejunostomy while 80 patients received end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture .The risk factors of early complications are analysed, and the incidence rates of pancreatic leakage, intraoperative blood loss and hospitalization of the two different operation type are compared.Result:The risk factors of early complications of pancrea- ticoduode- nectomy include preoperative jaundice (OR=7.1556), preoperative diabetes mellitus (OR=4.1046), preoperative serum albumin<30 g/L(OR=2.1162), and u type anastomosis(OR=2.1262). The incidence rates of the pancreatic leakage and bleeding in patients receiving end-to-end invagination pancreaticojeju- nostomy with circle discontinuous U suture are lower compared to those receiving end-to-end invagination pancreas- ticojejunostomy (p<0.05), end-to- end invagination pancreaticojeju- nostomy with circle discontinuous U suture is superior to end-to-end invagination pancreaticojeju- nostomy considering operation time, intraoperative blood loss and hospitalization (p<0.05). Conclusion: 1.Jaundice, diabetes mellitus,preoperative serum albumin level and method of pancreaticojejunastomy are early complication risk factors of PD.2. Compared to traditional method end-to-end invagination pancreas- ticojejunostomy with circle discontinuous U suture indicates lower rates of pancreatic leakage and bleeding.It is a safer and more reasonable method with rational design and easy operation.