Effect of Sealing One-Layer Anastomosis Technique in Pancreaticojejunostomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 MACheng-zhi ,  SUNYan , ZHANGHai-feng , ZHANGLei , ZENGZhao-lin

Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China;

Corresponding?author：

SUNYan, Email: 13936099121@163.com

Keywords：

Pancreaticoduodenectomy; Pancreatic fistula; Anastomosis

DOI：

10.7507/1007-9424.20160155

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate effect of sealing one-layer anastomosis in pancreaticojejunostomy in patients underwent pancreaticoduodenectomy. Methods The clinical data of 85 patients underwent pancreaticoduodenectomy in this hospital from January 2014 to May 2015 were collected. Of all the patients, 28 patients were underwent sealing onelayer anastomosis in pancreaticojejunostomy (sealing one-layer anastomosis group), 27 patients were underwent ductto-mucosa pancreaticojejunostomy (duct-to-mucosa anastomosis group), and 30 patients were underwent end-to-side invaginated pancreaticojejunostomy (end-to-side invagination group). The anastomosis time, time to pull out drainage tube, postoperative hospital stay, and incidence rate of postoperative pancreatic fistula were compared among these three groups. Results ①The anastomosis time (min) of the sealing one-layer anastomosis group was significantly shorter than that of the duct-to-mucosa anastomosis group or end-to-side invagination group (12.51±2.96 versus 25.65±3.35, P < 0.05; 12.51±2.96 versus 23.73±5.27, P < 0.05).②The time to pull out drainage tube of the sealing one-layer anastomosis group was significantly shorter than that of the end-to-side invagination group (7.65±1.30 versus 11.15±3.47, P < 0.05).③The postoperative hospital stay had no statistical significances among these three groups (P > 0.05).④The incidence of pancreatic fistula was 3.57% (1/28), 7.41% (2/27), and 10.00% (3/30) among the sealing one-layer anastomosis group, duct-to-mucosa anastomosis group, and end-to-side invagination group respectively, which had no statistical differences among these three groups (P > 0.05). Conclusion Sealing one-layer anastomosis in pancreaticojejunostomy might be a safe anastomosis, and it has advantages of simple operation and short operation time.

Citation： MACheng-zhi, SUNYan, ZHANGHai-feng, ZHANGLei, ZENGZhao-lin. Effect of Sealing One-Layer Anastomosis Technique in Pancreaticojejunostomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(5): 577-580. doi: 10.7507/1007-9424.20160155 Copy

1.	Kausch W. Das carcinoma der papilla duodeni und seine redikale entfemung. Beitrage Z Klin Chir, 1912, 78:439-486.
2.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4):763-779.
3.	Hoem D, Viste A. Improving survival following surgery for pancreatic ductal adenocarcinoma-a ten-year experience. Eur J Surg Oncol, 2012, 38(3):245-251.
4.	Popescu I, Dumitra?cu T. Pancreatoduodenectomy-past, present and future. Chirurgia, 2011, 106(3):287-296.
5.	Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. Am J Surg, 2002, 183(1):42-52.
6.	Catz-Snir V, Schachter P, Shimonov M, et al. Aggressive surgical approach in pancreatic cancer-is it justified? Harefuah, 2001, 140(2):117-120, 190.
7.	Zovak M, Mu?ina Mi?i? D, Glav?i? G.胰腺手術:演變及目前的個體化方案.中國普通外科雜志, 2015, 24(3):303-311.
8.	DeOliveira ML, Winter JM, Schafer M, et al. Assessment of complications after pancreatic surgery:A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg, 2006, 244(6):931-937.
9.	唐雪琴, 苗毅.胰腸吻合新的理解-從機械連接到生物愈合.中國普通外科雜志, 2015, 24(9):1213-1215.
10.	李志鵬, 鄭萬仁, 李巖, 等.胰胃吻合術的應用及其并發癥的研究進展.中國普外基礎與臨床雜志, 2014, 21(8):1034-1039.
11.	Zhang L, Li Z, Wu X, et al. Sealing pancreaticojejunostomy in combination with duct parenchyma to mucosa seromuscular onelayer anastomosis:a novel technique to prevent pancreatic fistula after pancreaticoduodenectomy. J Am Coll Surg, 2015, 220(5):e71-e77.
12.	楊媛媛, 黃鶴光, 陳燕昌, 等.胰腺空腸端側套入式胰管空腸黏膜吻合200例經驗.中國普外基礎與臨床雜志, 2013, 20(7):724-727.
13.	朱建平, 宿硯明, 黃慶榮, 等.套入式胰腸漿肌層U型貫穿縫合固定術-簡易的胰腸吻合新方法.中國現代普通外科進展, 2015, 18(7):554-555.
14.	蔣奎榮, 錢棟, 苗毅.胰腺手術后胰瘺防治研究進展.中國實用外科雜志, 2015, 35(8):904-906.
15.	Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition. Surgery, 2005, 138(1):8-13.
16.	張太平, 徐建威, 趙玉沛.胰腺癌根治術常見并發癥與處理原則.中華普外科手術學雜志:電子版, 2013, 7(3):172-175.
17.	李劉誠.胰十二指腸切除術后腹腔感染的臨床研究.新疆醫科大學, 2014.
18.	田夫, 向進見, 李明忠, 等.不同胰腸吻合方式的臨床效果比較.世界華人消化雜志, 2009, 17(30):3160-3163.
19.	黃鶴光, 陳志耀, 劉多謀.胰腸吻合術式百年變遷.中國普外基礎與臨床雜志, 2013, 20(7):709-712.
20.	孫鐵為, 劉軍, 孫世波.胰腸端側吻合應用橋袢式引流術臨床應用效果.中國現代手術學雜志, 2011, 15(6):427-430.
21.	El Nakeeb A, Salah T, Sultan A, et al. Pancreatic anastomotic leakage after pancreaticoduodenectomy. Risk factors, clinical predictors, and management (single center experience). World J Surg, 2013, 37(6):1405-1418.
22.	王建承.胰腸吻合技術的發展.外科理論與實踐, 2013, 18(6):512-514.
23.	張宏煒, 王太洪.胰十二指腸切除術后不同胰腸吻合方式的效果與評價.肝膽外科雜志, 2012, 20(2):91-93.
24.	Grobmyer SR, Kooby D, Blumgart LH, et al. Novel pancreaticojejunostomy with a low rate of anastomotic failure-related complications. J Am Coll Surg, 2010, 210(1):54-59.
25.	Kwon YJ, Ahn BK, Park HK, et al. One layer end-to-side pancreaticojejunostomy using reinforcing suture on the pancreatic stump. Hepatogastroenterology, 2013, 60(126):1488-1491.

1. Kausch W. Das carcinoma der papilla duodeni und seine redikale entfemung. Beitrage Z Klin Chir, 1912, 78:439-486.
2. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4):763-779.
3. Hoem D, Viste A. Improving survival following surgery for pancreatic ductal adenocarcinoma-a ten-year experience. Eur J Surg Oncol, 2012, 38(3):245-251.
4. Popescu I, Dumitra?cu T. Pancreatoduodenectomy-past, present and future. Chirurgia, 2011, 106(3):287-296.
5. Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy. Am J Surg, 2002, 183(1):42-52.
6. Catz-Snir V, Schachter P, Shimonov M, et al. Aggressive surgical approach in pancreatic cancer-is it justified? Harefuah, 2001, 140(2):117-120, 190.
7. Zovak M, Mu?ina Mi?i? D, Glav?i? G.胰腺手術:演變及目前的個體化方案.中國普通外科雜志, 2015, 24(3):303-311.
8. DeOliveira ML, Winter JM, Schafer M, et al. Assessment of complications after pancreatic surgery:A novel grading system applied to 633 patients undergoing pancreaticoduodenectomy. Ann Surg, 2006, 244(6):931-937.
9. 唐雪琴, 苗毅.胰腸吻合新的理解-從機械連接到生物愈合.中國普通外科雜志, 2015, 24(9):1213-1215.
10. 李志鵬, 鄭萬仁, 李巖, 等.胰胃吻合術的應用及其并發癥的研究進展.中國普外基礎與臨床雜志, 2014, 21(8):1034-1039.
11. Zhang L, Li Z, Wu X, et al. Sealing pancreaticojejunostomy in combination with duct parenchyma to mucosa seromuscular onelayer anastomosis:a novel technique to prevent pancreatic fistula after pancreaticoduodenectomy. J Am Coll Surg, 2015, 220(5):e71-e77.
12. 楊媛媛, 黃鶴光, 陳燕昌, 等.胰腺空腸端側套入式胰管空腸黏膜吻合200例經驗.中國普外基礎與臨床雜志, 2013, 20(7):724-727.
13. 朱建平, 宿硯明, 黃慶榮, 等.套入式胰腸漿肌層U型貫穿縫合固定術-簡易的胰腸吻合新方法.中國現代普通外科進展, 2015, 18(7):554-555.
14. 蔣奎榮, 錢棟, 苗毅.胰腺手術后胰瘺防治研究進展.中國實用外科雜志, 2015, 35(8):904-906.
15. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition. Surgery, 2005, 138(1):8-13.
16. 張太平, 徐建威, 趙玉沛.胰腺癌根治術常見并發癥與處理原則.中華普外科手術學雜志:電子版, 2013, 7(3):172-175.
17. 李劉誠.胰十二指腸切除術后腹腔感染的臨床研究.新疆醫科大學, 2014.
18. 田夫, 向進見, 李明忠, 等.不同胰腸吻合方式的臨床效果比較.世界華人消化雜志, 2009, 17(30):3160-3163.
19. 黃鶴光, 陳志耀, 劉多謀.胰腸吻合術式百年變遷.中國普外基礎與臨床雜志, 2013, 20(7):709-712.
20. 孫鐵為, 劉軍, 孫世波.胰腸端側吻合應用橋袢式引流術臨床應用效果.中國現代手術學雜志, 2011, 15(6):427-430.
21. El Nakeeb A, Salah T, Sultan A, et al. Pancreatic anastomotic leakage after pancreaticoduodenectomy. Risk factors, clinical predictors, and management (single center experience). World J Surg, 2013, 37(6):1405-1418.
22. 王建承.胰腸吻合技術的發展.外科理論與實踐, 2013, 18(6):512-514.
23. 張宏煒, 王太洪.胰十二指腸切除術后不同胰腸吻合方式的效果與評價.肝膽外科雜志, 2012, 20(2):91-93.
24. Grobmyer SR, Kooby D, Blumgart LH, et al. Novel pancreaticojejunostomy with a low rate of anastomotic failure-related complications. J Am Coll Surg, 2010, 210(1):54-59.
25. Kwon YJ, Ahn BK, Park HK, et al. One layer end-to-side pancreaticojejunostomy using reinforcing suture on the pancreatic stump. Hepatogastroenterology, 2013, 60(126):1488-1491.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Sealing One-Layer Anastomosis Technique in Pancreaticojejunostomy

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content