Safety And Feasibility Assessment Of U-type Penetrating And Interlocking Pancreaticojejunostomy In Clinical Applications

Objective : To investigate the safety and feasibility of U-type penetrating and interlocking pancreaticojejunostomy in this medical center,and to provide evidence for clinical application.Methods : A retrospective study was performed on 57 patients with pancreaticoduodenectomy(pancreatic duct diameter <3 mm)who underwent general surgery at the Anhui Provincial Hospital from September 2016 to September 2018.To study the U-type penetrating and interlocking pancreaticojejunostomy(n=18)and duct-to-mucosal pancreaticojejunostomy(n=39)in the operation of pancreaticojejunostomy time ? postoperative hospital stay,postoperative pancreatic fistula(POPF),gastric emptying disorder(DGE).The incidence of abdominal infection and postoperative hemorrhage(PPH).Among the subjects,34 were males and 23 were females with an average age of 60.23 years.Results: All the 57 patients underwent successful operation.The average anastomosis time of the U-type penetrating and interlocking pancreaticojejunostomy was 15.00 minutes.The drainage fluid amylase increased in 4 cases,3 cases were biochemical leak(BL),1 case of Grade B pancreatic fistula,accompanied by gastrointestinal bleeding after symptomatic treatment,3 patients had gastric emptying disorder,the average hospital stay was 12.83 ± 3.19 days;The average anastomosis time of duct-to-mucosal pancreaticojejunostomy was 23.97 minutes.The drainage fluid amylase increased in 10 cases,including 7 cases of biochemical leak,3 cases of grade B pancreatic fistula,2 cases of abdominal cavity hemorrhage caused by grade Bpancreatic fistula,and 1 case of abdominal infection caused by grade B pancreatic fistula.Eight patients had gastric emptying disorder after operation,and the average hospital stay was 13.08±2.60 days.The average anastomosis time of the U-type penetrating and interlocking pancreaticojejunostomy group was significantly shorter than that of the duct-to-mucosal group,and the difference was statistically significant(P<0.05).There was no significant difference in the difference between pancreatic fistula,postoperative hemorrhage,abdominal infection and postoperative hospital stay.Conclusion : There is no significant difference in the incidence of postoperative complications between the U-type penetrating and interlocking pancreaticojejunostomy and the duct-to-mucosal pancreaticojejunostomy.However,it can significantly shorten the anastomosis time and is an effective improvement of the pancreaticojejunostomy.