Abstract
LPD has been cautiously regarded as feasible and safe for resection and reconstruction. However, anastomosis of the remnant pancreas is still thought to be a critical obstacle to the dissemination of LPD in general practice. This study presents a new technique of pancreaticojejunostomy for nondilated pancreatic duct and evaluates its safety and reliability. From July 2014 to June 2015, a total of 52 patients underwent LPD with the new technique. A modified technique of duct-to-mucosa PJ was performed with transpancreatic interlocking mattress sutures, named the imbedding duct-to-mucosa PJ. Then the morbidity and mortality was calculated. This technique was applied in 52 patients after LPD all with nondilated pancreatic duct (1-3mm). The mean operation time was 4.6h (range, 3.5-8.3h) and the median time for the anastomosis was 37min (range, 24-53min). Operative mortality was zero, and morbidity was 21.2% (n=11), including hemorrhage (n=3, 5.8%), biliary fistula (n=1, 1.9%), pulmonary infection (n=1, 1.9%), delayed gastric emptying (n=2, 3.8%), abdominal abscess caused by biliary fistula or PF formation (n=2, 3.8%), and POPF (n=2, 3.8%). Two patients developed a pancreatic fistula (one type A, one type B) classified according to the International Study Group on Pancreatic Fistula. The described technique is a simple and safe reconstruction procedure after LPD, especially for patients with nondilated pancreatic duct.
Published Version
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