Abstract:
Objective To investigate the clinical value of gastroduodenal artery‑stump pro-tection technology (GDAPT) in laparoscopic pancreaticoduodenectomy (LPD).
Methods The retro-spective cohort study was conducted. The clinical data of 288 patients who underwent LPD in The Second Hospital of Hebei Medical University from October 2021 to May 2024 were collected. There were 172 males and 116 females, aged (60±7)years. Of the 288 patients, 186 patients undergoing LPD with GDAPT were divided into the intervention group, including 78 cases with GDAPT using ligamentum teres hepatis and 108 cases with GDAPT using left‑lateral lobe and hepatic caudate lobe, 102 patients undergoing LPD without GDAPT were divided into the control group. Observation indicators: (1) surgical situations; (2) postoperative complications and prognosis. Comparison of measurement data with normal distribution between groups was conducted using the independent sample t test. Comparison of measurement data with skewed distribution between groups was conducted using the Mann‑Whitney U test. Comparison of count data between groups was conducted using the chi-square test.
Results (1) Surgical situations. All 288 patients completed LPD successfully. There was no significant differences in operation time, the volume of intraoperative blood loss and intraoperative blood transfusion between the two groups (P>0.05). (2) Postoperative complications and prognosis. Cases with postoperative hemorrhage, duration of postoperative hospital stay, cases dead during postoperative 30 days were 7 in the control group, 15.0(14.0,18.0) days, 2 in the intervention group, respectively, versus 14, 17.5(15.0,19.0)days, 7 in the control group, respectively, showing significant differences between the two groups (χ²=9.67, Z=-2.79, χ²=5.50, P<0.05).
Conclusion Compared with no GDAPT, application of GDAPT in LPD can significantly reduce the postoperative hemorrhage rate, mortality and shorten the postoperative hospital stay without increasing the surgical risk.