A novel lamellar duct-to-mucosa pancreaticojejunostomy decreases the incidence of pancreatic fistula after pancreaticoduodenectomy

Abstract

Objective To investigate the influence of different pancreaticojejunostomy on the incidence of postoperative pancreatic (PF) fistula in pancreaticoduodenectomy (PD). Methods The clinical data of 343 patients undergoing radical PD from January 2011 to December 2015 were collected. 343 patients were divided into 3 groups, including 124 cases of continuous lamellar duct-to-mucosa pancreaticojejunostomy (CL-DMP) (group A), 111 cases of invaginated pancreaticojejunostomy (group B) and 108 cases of binding pancreaticojejunostomy (group C). The rates of postoperative PF and related complications, length of postoperative hospital stay, perioperative mortality and hospitalization costs were compared between the 3 groups. Results There was no statistical difference in the size of pancreatic duct between the 3 groups (P>0.05). The postoperative PF incidence of group A was 4.84%, significantly lower than 13.51% in group B and 15.74% in group C, respectively (P<0.05). The anastomosis took less time and postoperative hospital stay was shorter in group A than that in the other 2 groups (P<0.05). Conclusion CL-DMP is time-saving, safe and effective method of pancreaticojejunostomy during the process of pancreaticoduodenectomy. Key words: Pancreaticoduodenectomy; Pancreaticojejunostomy; Pancreatic fistula