Comparison Between The Placement With And Without Pancreatic Duct Stent In The Pancreaticoduodenectomy

BackgroundPancreaticoduodenectomy is one of the most complex and most risky procedures in abdominal surgery.The incidence of postoperative complications is high,and pancreatic fistula is the most common and most serious postoperative complication.There is a wide range of controversy that will the incidence of pancreatic fistula reduced by place the pancreatic duct tube and drainage outside of the body in the process of pancreaticojejunostomy.However,the reports of relevant randomized controlled trials are scarce.ObjectiveTo evaluate the clinical effect of different ways of pancreaticojejunostomy in the treatment of pancreaticoduodenectomy,and to investigate the applicability of the pancreaticojejunostomy without pancreatic duct stent.MethodFrom January 2012 to December 2015,87 cases of patients with feasible pancreaticoduodenectomy,according to the random allocationmethod for the group that duct-to-mucosa anastomosis with pancreatic duct stent drainage out of body(Group A,43 cases)and group that pancreas-jejunum end-to-side anastomosis without stent.(Group B,44cases),compare the time of two different ways of pancreaticojejunostomy and postoperative hospital stay,incidence of postoperative complications.ResultsThe time of without pancreatic duct stent during operation was significantly less than that with pancreatic duct stent(t=7.137,P<0.05).The postoperative hospitalization time of patients in group B was less than that in group A(t=2.408,P<0.05,the difference was statistically significant).The incidence of postoperative complications such as pancreatic fistula,abdominal bleeding,abdominal infection,delayed gastric empting,the difference was not statistically significant between the two groups(?2=0.181,0.322,0.603,0.001,P > 0.05).ConclusionIt is safe and reliable that without pancreatic duct stent during pancreaticoduodenectomy,which can reduce the operation time and the length of hospital stay,whereas there was no significant difference in the incidence of postoperative complications.