To Study The Related Factors, Prevention And Treatment With The Postoperative Complications Of Pancreaticoduodenectomy

Background and Objective Pancreaticoduodenectomy (Pancreaticoduodenctomy,PD) is the classic treatment with some malignant cancer including pancreatic head andneck, duodenum, ampulla of Vater as well as some benign diseases. The operation isextensive, high degree of difficulty and time-consuming, and of more intraoperativebleeding, It is one of the most complex abdominal surgical operation because of thevarious and serious postoperative complications. It has been tireless pursuit for Surgeonsto improve the operation mode, reduce postoperative complication and further to makethe patient recover successfully. This study is from the perspective of the surgicaltreatment, to explore the effect of pancreatic torn of pancreaticoduodenectomy,themethod of pancreaticojejunostomy, reasonable application of drainage,postoperativesomatostatin and enteral nutrition on the prevention and treatment of postoperativecomplications with patients.METHODS: we studied retrospectively the postoperative clinical data of our hospitalpatient with pancreatoduodenectomy, analysised the related factors of PD postoperativecomplications, determined the prevention measures according to these factors, improvedthe operational details of surgery and postoperative management, then to observe theincidence rate of postoperative complications.RESULTS:1.There was no statistical significance between the relevance of statisticalfactors and postoperative complications by retrospective analysis. Comparativeadvantage in the statistical factors was: Sexr> drainage> Body Mass Index>pancreaticojejunostomy type> preoperative hemoglobin> amount of blood transfusion> preoperative total bilirubin> age> preoperative albumin> surgery time. Female obesepatients postoperative complications incidence rate probability is higher, the reasons oweto objective factor. Drainage of pancreatic juice and pancreatic anastomosis can beimproved operation, If improved operation details, would reduced the incidence ofpostoperative complications.2Postoperative complications: None of patients suffered of pancreatic fistula in thepatients operatived by the improved surgical groop. other postoperative complicationswere significantly reduced. There were statistically significant between the two groups ofpatients with postoperative complications.(P <0.05), Postsurgical gastroparesissyndrome(PGS)was the common complications after pancreaticoduodenectomy.Enteralnutrition tube was conventionally placed into Jejunum It is useful for the conservative treatment ofPGS.3. Influence of somatostatin on pancreatic secretion:The amount of pancreatic secretioninhibited by Somatostatin was about30%and hardly no more than50%.CONCLUSION：Postoperative complications of Pancreaticoduodenectomy are affectedby many factors, If a professional Operation group could preoperatively study the relatedfactors, further to establish the relevant improvement measures, then the incidence rateof postoperative complications would decrease. Our research shows that:（1）Improved jejunum-turn-inward–anastomosis operative procedure can preventand control pancreatic fistula from multiple perspective. The Surgical procedure is safe,reliable, and can significantly reduce the incidence rate of complications afterpancreaticoduodenectomy.（2）The drainage of the pancreatic juice and the application of Somatostatin hasplayed an important role in preventing pancreatic fistula.（3）Postsurgical gastroparesis syndrome(PGS)was the most common complicationsafter pancreaticoduodenectomy，the placement of enteral nutrition tube is useful for the conservative treatment with PGS not only in terms of the gastrointestinal function earlyrecovery, but also in the prevention and treatment of PGS.