Clinical Study On Improvement Of Gastrointestinal Decompression Tube To Prevent Pancreatic Fistula After Pancreatoduodenectomy

Objective:To investigate the clinical efficacy and mechanism on Improvement of gastrointestinal decompression tube to prevent the pancreatic fistula after pancreaticoduodenectomy Methods:The study was a retrospective analysis. A total of 54 patients undergoing PD with complete general information and clear diagnosis of bile duct carcinoma, pancreatic carcinoma and Ampulla tumor etc from January 2014 to January 2016 were divided into modified group(n=24)and normal group(n=30) according to whether the tube is improved。The ways to improve gastrointestinal decompression tube are as following:On the basis of commonly useing the tube, put the tube through gastrointestinal anastomotic input loop about 15 cm,and then into pancreatic intestinal anastomotic input loops,meantime increasing or cutting out 4 to 6 the lateral hole for the aim to drainage input loops and residual stomach cavity. The morbidity of pancreatic fistula, liquid drainage of amylase and related indicators were compared between the two groups.Results:Modified than normal group can obviously reduced the morbidity of pancreatic fistul {8.3%( 2/24) VS 30.0%( 9/30), X2=3.859,P=0.049,},the difference of incidence rate of pancreatic fistula between two groups was statistically significant(P<0.05).And compared to normal group, in modified group,the amylase levels in the gastric tube{(97861.71±42153.695)IU/L vs(73775.87±12450.190)IU/L,t=2.706,P=0.012,} and the volume of drainage {(302.08±89.198)ml vs(206.33±145.921)ml,t=2.967,P=0.005,} were also statistically significant.Conclusions:The improvement of gastrointestinal decompression tube can effectively reduce the morbidity of pancreatic fistula aftcr pancreaticoduodenectomy, which is safe and feasibl. One of the mechanisms is by increasing the lateral hole and deeped into the pancreatic anastomosis input loops, it can maximize drainage of digestive juicesin early in the digestive tract reconstruction, especially in pancreatic juice.