Clinical application of modified parachute-like pancreaticojejunostomy for pancreatoduodenectomy

Abstract

Objective To explore the effect of modified parachute-like pancreaticojejunostomy on incidence of pancreatic fistula after pancreatoduodenectomy. Methods The clinical data of 123 patients undergoing pancreatoduodenectomy with application of duct-to-mucoca pancreaticojejunostomy were analyzed retrospectively. Interrupted suture technique and modified parachute suture technique were performed in 61 and 62 patients, respectively. Postoperative complications, data during and after pancreatoduodenectomy between two groups were compared. Results There were no significant differences in pancreatic texture, pylorus preservation, pancreatic duct drainage, intraoperative blood loss, and operating time between two groups (P>0.05). No significant differences between two groups were observed on postoperative morbidity of gastrointestinal or intraabdominal hemorrhage, delayed gastric emptying, and intraabdominal abscess (P>0.05). Although there was no significant difference in the incidence of postoperative pancreatic fistula (P>0.05), the grades B/C postoperative pancreatic fistula in modified parachute suture group was significantly less than in interrupted suture group (P<0.05). Conclusions Modified parachute-like pancreaticojejunostomy technique in pancreatoduodenectomy can reduce the incidence of severe postoperative pancreatic fistula. Key words: Pancreaticojejunostomy/MT; Pancreaticoduodenectomy/AE; Pancreatic fistula/ET/PC; Intestinal fistula/ET/PC