A new simple and safe technique of end-to-end invaginated pancreaticojejunostomy with transpancreatic U-sutures-early postoperative outcomes in consecutive 88 cases

作者：Chen Xiao Ping^*; Qiu Fa Zu; Zhang Zhi Wei; Chen Yi Fa; Huang Zhi Yong; Zhang Wan Guang

来源：Langenbeck's Archives of Surgery, 2009, 394(4): 739-744.

DOI：10.1007/s00423-009-0487-7

• End-to-end pancreaticojejunostomy
• Transpancreatic U-suture
• Pancreatic fistula
• Pancreatic cancer

Postoperative pancreatic fistula (POPF) remains a leading cause of morbidity and mortality after pancreaticoduodenectomy (PD). Thus, a number of technical modifications regarding the pancreato-enteric anastomosis after PD have been proposed to reduce POPF rate. Until now, there is no consensus on which is the best. This study presents a new technique of the end-to-end invaginated pancreaticojejunostomy with two to three transpancreatic U-sutures and evaluates its safety and reliability.
From 2002 to 2007, 88 patients (54 men and 34 women) underwent an invaginated end-to-end pancreaticojejunostomy with two to three transpancreatic U-sutures after PD. The mean age was 52.4 years (range, 26-74 years). The diseases of the all patients were malignant.
In all patients of this study, two transpancreatic U-sutures were performed in 59 and three U-sutures in 29. The median duration of surgery was 3.8 h (range 3-6.5) and the median time to perform pancreaticojejunostomy was 13.3 min (range 8-25). The median blood loss was 750 ml (range 300-1,800), 36 patients needed transfusion and the median blood transfusion was 380 mL (range 200-1,200). Overall morbidity occurred in 15 patients (17.0%). Only two patients (2.2%) had grade A of POPF and no patient had grade B and grade C of POPF. No operative death occurred.
An invaginated end-to-end pancreaticojejunostomy with two to three transpancreatic U-sutures is simple, rapid, safe, and reliable technique, even in some patients with soft pancreas and small pancreatic duct.

• 出版日期2009-7
• 单位华中科技大学