• RCCSE中国核心学术期刊(A+)
  • 中国百强报刊
  • 百种中国杰出学术期刊
  • 中国精品科技期刊
  • 中国高校百佳科技期刊
  • 中国自然科学类核心期刊
  • 中国科技论文统计源期刊
  • 中华医学会优秀期刊
  • 中国精品科技期刊顶尖学术论文(5000)项目来源期刊
  • 入选中国高质量科技期刊分级目录(消化病学)T1级
  • 入选《中国学术期刊影响因子年报(自然科学与工程技术)》Q1区
  • 入选《科技期刊世界影响力指数(WJCI)报告(2022)》
  • RCCSE中国核心学术期刊(A+)
  • 中国百强报刊
  • 百种中国杰出学术期刊
  • 中国精品科技期刊
  • 中国高校百佳科技期刊
  • 中国自然科学类核心期刊
  • 中国科技论文统计源期刊
  • 中华医学会优秀期刊
  • 中国精品科技期刊顶尖学术论文(5000)项目来源期刊
  • 入选中国高质量科技期刊分级目录(消化病学)T1级
  • 入选《中国学术期刊影响因子年报(自然科学与工程技术)》Q1区
  • 入选《科技期刊世界影响力指数(WJCI)报告(2022)》
Zhu Yongsheng, Zhu Xuefeng, Chen Yijun. Clinical value of penetratingsuture type of pancreaticojejunostomy after pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2014, 13(11): 867-870. DOI: 10.3760/cma.j.issn.1673-9752.2014.11.008
Citation: Zhu Yongsheng, Zhu Xuefeng, Chen Yijun. Clinical value of penetratingsuture type of pancreaticojejunostomy after pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2014, 13(11): 867-870. DOI: 10.3760/cma.j.issn.1673-9752.2014.11.008

Clinical value of penetratingsuture type of pancreaticojejunostomy after pancreaticoduodenectomy

More Information
  • Objective:To investigate the clinical value of penetrating suture type pancreaticojejunostomy (PPJ) after pancreaticoduodenectomy (PD).
    Methods: The clinical data of 77 patients who received pancreatico duodenectomy from Taixing People′s Hospital from June 2002 to March 2012 were retrospectively analyzed. Of all the patients, 34 received PPJ after PD (PPJ group), and the other 43 patients received PJ anastomosis (control group) based on the texture and size of the pancreas, pancreatic duct diameter (duct to mucosa pancreaticojejunostomy for pancreatic duct diameter≥ 4 mm, end to end or binding pancreaticojejunostomy for pancreatic duct diameter ≤3 mm). Pancreatic fistula was diagnosed according to the criteria of the International Study Group on Pancreatic Fistula, including grade B or C pancreatic fistula with clinical value. Patients were followed up through outpatient examination and telephone interview till May 2012. Data were presented by 〖AKx-D〗 ±s or median (range) and the t test and Wilcoxon rank sum test were used to evaluate quantitative data with or without normal distribution, respectively. Qualitative data were analyzed using Pearson χ 2  test or Fisher′s exact test.
    Results:The mean diameter of the pancreatic duct was 3 mm for both the PPJ group and the control group. The external drainage via the pancreatic duct stent was not used in the PPJ group, compared with 4 cases in the control group, showing a statistically significant difference between the 2 groups ( χ 2 =3.632, P<0.05). The duration of pancreaticojejunostomy was 12 minutes (range, 8 25 minutes) in the PPJ group, while no records in the control group. The operation time and intraoperative blood loss in the PPJ group and the control group were (304±60)minutes and (475±75)mL, (304±60)minutes and (500±97)mL, respectively. Twenty four (70.6%) patients in the PPJ group and 29 (67.4%) patients in the control group received intraoperative blood transfusion, with volume of 400 mL (range, 300 800 mL) and 600 mL (range, 300 1 200 mL), respectively. The median duration of postoperative hospital stay were 18 days (range, 11 32 days) in the PPJ group and 20 days (range, 9 44 days) in the control group. None of these comparisons were statistically significant between the 2 groups ( t=1.293,  0.619, χ 2 =0.088,  Z=0.165, 0.074, P>0.05). The rate of grade B or C pancreatic fistula were 0 for the PPJ group and 27.9% (12/43) for the control group, and the mortality rate of patients who had pancreatic fistula were 0 and 11.6%(5/43) for the PPJ group and the control group, with statistical significance ( χ 2 =11.232, 4.237, P<0.05). The overall incidence of bile leakage, peritoneal bleeding and delayed gastric emptying in the PPJ group and the control group were 5.9%(2/34), 2.9%(1/34), 5.9%(2/34) and 11.6%(5/43), 7.0%(3/43), 14.0%(6/43), with no significance difference ( P>0.05). Fifty six patients were followed up after operation from 9 months to 5 years. Pancreatic duct dilation was detected by imaging examination for 26 patients in the control group.
    Conclusion:PPJ is a simple and feasible approach with better clinical efficacy after PD.

  • Related Articles

    [1]Feng Liangyong, Li Xiao, Yue Shuqiang. Research progress in the selection of pancreaticojejunostomy suture in pancreaticoduodenec-tomy[J]. Chinese Journal of Digestive Surgery, 2023, 22(4): 566-570. DOI: 10.3760/cma.j.cn115610-20230306-00100
    [2]Zhou Jiang, Yang Jingrui, Xiao Rui, Wang Lu, Zhang Qian, Wang Jiaxing, Wen Bo, Ren Jianjun. Clinical application value of modified invagination for pancreaticojejunostomy in pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2019, 18(7): 668-674. DOI: 10.3760/cma.j.issn.1673-9752.2019.07.011
    [3]Du Hanpeng, Chen Wei, Huang Li, Zhang Kunsong, Liang Lijian, Lai Jiaming. Risk factors analysis of pancreatic fistula after pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2018, 17(7): 724-728. DOI: 10.3760/cma.j.issn.1673-9752.2018.07.016
    [4]Luo Haifeng, Gao Xue, Du Jian, Ning Zhen, Ma Chi, Tan Guang.. Analysis of risk factors of postoperative pancreatic fistula after pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2017, 16(10): 1036-1041. DOI: 10.3760/cma.j.issn.1673-9752.2017.10.011
    [5]Wei Jinping, Su Zhilei, Wu Dehai, Shan Baga, Tai Sheng.. Application value of one half layer pancreaticojejunostomy with the posterior wall of pancreas reinforced in pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2016, 15(12): 1200-1204. DOI: 10.3760/cma.j.issn.1673-9752.2016.12.013
    [6]Li Yan, Zhang Lei, Zeng Zhaolin, Sun Yan. Application value of endtoside closed in situ pancreaticojejunostomy in pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2015, 14(11): 925-929. DOI: 10.3760/cma.j.issn.1673-9752.2015.11.009
    [7]Yang Yongsheng, Xie Yingjun, Lin Chao, Xuan 〖JP2〗Wei, E Changyong, Sheng Jiyao, Li Wei, Zhang Xuewen. Application value of end to end invagination pancreaticojejunostomy with discontinuous U suture in the pancreatic head cancer[J]. Chinese Journal of Digestive Surgery, 2015, 14(8): 630-634. DOI: 10.3760/cma.j.issn.1673-9752.2015.08.008
    [8]Wang Weishen, Shen Baiyong, Deng Xiaxing,  Zhan Qian, Wu Zhichong, Peng Chenghong. Risk factors of pancreatic fistula after pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2014, 13(7): 531-534. DOI: 10.3760/cma.j.issn.1673-752.2014.07.008
    [9]ZHONG Jing tao, ZHOU Wu yuan, ZHANG Bo, LI Lei, SHI Xue tao. Effects of improved end to end invagination pancreaticojejunostomy on the occurrence of pancreatic fistula after pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2013, 12(2): 131-134. DOI: 10.3760/cma.j.issn.1673-9752.2013.02.011
    [10]ZHANG Guang ya, ZHOU Jing shi, LI Hai min, YU Heng chao, WANG Lin, DOU Ke feng. Application of pancreaticojejunostomy procedures selection strategy in pancreaticoduodenectomy[J]. Chinese Journal of Digestive Surgery, 2013, 12(2): 124-127. DOI: 10.3760/cma.j.issn.1673-9752.2013.02.009

Catalog

    Article views (9895) PDF downloads (0) Cited by()

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return