Application Of Modified One-layer End-to-end Pancreaticojejunostomy In Pancreaticoduodenectomy

Objective To explore and analyze the safety and reliability of modified end-to-end pancreaticojejunostomy in pancreaticoduodenectomy.Methods The clinical data of 102 patients who underwent pancreaticoduodenectomy in hepatobiliary and pancreatic surgery department of our hospital from January 2015 to December 2017 were collected for retrospective analysis.According to the different ways of pancreaticojejunostomy,patients were divided into the modified one-layer end-to-end pancreaticojejunostomy group(group A,n=67)and the duct-to-mucosa pancreaticojejunostomy group(group B,n=35).The general conditions,operation time,blood loss,postoperative pancreatic fistula,biliary fistula,delayed gastric emptying,infection and other complications in the two groups were compared.Results Postoperative pancreatic fistula occurred in 11 cases(10.8%)of 102 patients.There were 6 cases(9.8%)of pancreatic fistula in group A,including 5 cases of grade B pancreatic fistula,1 case of grade C pancreatic fistula,4 cases of bile fistula,4 cases of infection,2 cases of bleeding,3 cases of delayed gastric emptying(DGE)and 1 case of death.In group B,there were 5 cases of pancreatic fistula(14.3%),4 cases of grade B pancreatic fistula,1 case of grade C pancreatic fistula,3 cases of bile fistula,2 cases of infection,2 cases of bleeding,2 cases of gastric emptying,and 0 cases of death.The difference between the two groups was not significant.There were 10 cases(14.9%)of biochemical leak in group A,there were 11 cases of biochemical leak in group B(31.4%),and the difference between the two groups was significant.Conclusion The modified one-layer end-to-end pancreaticojejunostomy is also a safe,reliable and simple operation in pancreaticoduodenectomy.