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Effect of six-stitch pancreaticojejunostomy on pancreatic fistula:A propensity score-matched comparative cohort study

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Hepatobiliary & pancreatic Diseases International 2020年第3期19卷 277-283页

作者： Zhao-Lin Zeng Yan Sun Da Xue Pi-Li Liu Wang-Ming Chen Lei Zhang Department of General Surgery the Second Affiliated Hospital of Harbin Medical UniversityHarbin 150086China

Background:clinically relevant postoperative pancreatic fistula(CR-POPF)is the most common and severe complication after pancreaticoduodenectomy(PD).Despite the development of numerous anastomotic surgical techniques to minimize CR-POPF,more than 30%of patients who undergo PD develop ***,we propose a novel pancreaticojejunostomy(PJ)technique and evaluate its efficacy and safety compared to traditional ***:This retrospective study enrolled 164 consecutive patients who underwent PJ after PD between January 2012 and June *** them,78(47.6%)underwent traditional PJ and 86(52.4%)underwent sixstitch *** primary outcome was CR-POPF at 1-month follow-up defined according to the revised 2016 International Study Group on pancreatic Fistula *** adjust for baseline differences and selection bias,patients were matched by propensity scores,which left 63 patients with traditional PJ and 63 with six-stitch ***:Compared to patients who underwent traditional PJ(mean age 56.2±9.4 years),patients who underwent six-stitch PJ(mean age 57.4±11.4 years)had a lower CR-POPF *** risk of CR-POPF among patients who underwent six-stitch PJ was decreased by 81.7%after adjustment for age,sex,body mass index,and disease severity compared to patients who underwent traditional ***,the surgery time was reduced from 29 min for traditional PJ to 15 min for six-stitch PJ(P<0.001).Adverse effects such as abdominal fluid collection,abdominal bleeding,and wound infection were similar between two ***:Six-stitch PJ may be an effective and efficient PJ technique for patients who undergo PD surgery.

关键词： Duct-to-mucosa pancreaticoduodenectomy pancreaticojejunostomy clinically relevant postoperative pancreatic fistula

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