Reliability of Continuous Suture of Pancreaticojejunostomy after Pancreaticoduodenectomy

Abstract

Currently, there seems to be no optimized method of pancreaticojejunostomy, and numerous modifications have been used to reduce postoperative pancreatic fistula after pancreaticoduodenectomy. The aim of the present study was to assess the efficacy of continuous sutures for duct-to-mucosa pancreaticojejunostomy in pancreaticoduodenectomy and find predictive risk factors of postoperative pancreatic fistula. We retrospectively reviewed the medical records of 112 patients who underwent pancreaticoduodenectomy, which included patient's demographics, disease-related factors and operative risk factors. Between the interrupted suture and continuous suture groups, there was no significant difference in presence of preoperative biliary drainage, pancreas texture, the pancreatic duct diameter and the prevalence of coronary artery disease. Postoperative pancreatic fistula developed in 21 (18.8%) of the 112 patients who underwent pancreaticoduodenectomy. Only preoperative biliary drainage and operation type showed significant differences for developing pancreatic fistula in a multivariate analysis. The study revealed that the incidence of pancreatic fistula was similar in both the continuous and interrupted suture groups of pancreaticojejunostomy. Continuous suture group had shorter operative time, less damage, fewer knots and less tension than interrupted sutures. Therefore, we concluded that the continuous suture method is feasible and safe to apply to reconstructing pancreaticojejunostomy.