Effects Of Two Types Of Pancreaticojejunostomy On Pancreatic Fistula After Laparoscopic Pancreaticoduodenectomy

Objective: By comparing the effects of modified pancreaticoduoden ectomy and Duct-to-mucosa pancreaticojejunostomy on pancreatic fistula after laparoscopic pancreaticoduodenectomy,we explored a better pancreaticojejunostomy method,so as to better reduce the occurrence of pancreatic fistula after LPD,so as to benefit patients.Methods: Using retrospective study method,the selection in December 2016 to December 2020 in our line of Lpaparoscopic pancreaticoduodenectomy patients clinical data,a total of 69 cases,the research need to be collected metrics include: gender,age,body mass index,preoperative liver function(total bilirubin,alanine aminotransferase,albumin),preoperative complications(diabetes,chronic pancreatitis),pancreas(texture,pancreatic duct diameter),abdominal surgery history,pathological type,intraoperative blood loss,the pancreaticojejunostomy time,merge the pancreatic fistula,biliary fistula,bleeding,abdominal cavity infection,gastric paralysis.According to the different methods of intraoperative pancreaticojejunostomy,they were divided into three groups: group A: modified pancreaticojejunostomy group(39 cases),group B: duct-to-mucosa pancreaticojejunostomy group(30 cases).The correlation of postoperative complications between the two groups was compared,and the observed indexes were analyzed with statistical methods.Results: 1.The mean time of pancreaticojejunostomy in group A was(35.59±4.60)min,and that in group B was(43.63±4.41)min,the difference was statistically significant(P < 0.05).2.There was no grade C fistula in the two groups.The incidence of biochemical fistula was20.51%(8/39)in group A and 10%(3/30)in group B,and the difference was not statistically significant(P > 0.05).The incidence of grade B fistula was 5.13%(2/39)in group A and 26.67%(8/30)in group B,and the difference was statistically significant(P < 0.05).3.There was no significant difference in the incidence of postoperative4.bleeding,biliary fistula,abdominal infection and gastroparesis between the two groups(P > 0.05).Conclusions:1.Both of the two anastomotic methods have good clinical effect.2.Modified pancreaticojejunostomy can significantly reduce the grade of pancreatic fistula with higher safety. 3.The modified pancreaticojejunostomy can shorten the time of pancreaticojejunostomy and is easy to operate,which is worthy of clinical application.