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：

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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, Dumitraşcu 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, Mužina Mišić D, Glavčić G.胰腺手术:演变及目前的个体化方案.中国普通外科杂志, 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.胰肠吻合新的理解-从机械连接到生物愈合.中国普通外科杂志, 2015, 24(9):1213-1215.
10.	李志鹏, 郑万仁, 李岩, 等.胰胃吻合术的应用及其并发症的研究进展.中国普外基础与临床杂志, 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.	杨媛媛, 黄鹤光, 陈燕昌, 等.胰腺空肠端侧套入式胰管空肠黏膜吻合200例经验.中国普外基础与临床杂志, 2013, 20(7):724-727.
13.	朱建平, 宿砚明, 黄庆荣, 等.套入式胰肠浆肌层U型贯穿缝合固定术-简易的胰肠吻合新方法.中国现代普通外科进展, 2015, 18(7):554-555.
14.	蒋奎荣, 钱栋, 苗毅.胰腺手术后胰瘘防治研究进展.中国实用外科杂志, 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.	张太平, 徐建威, 赵玉沛.胰腺癌根治术常见并发症与处理原则.中华普外科手术学杂志:电子版, 2013, 7(3):172-175.
17.	李刘诚.胰十二指肠切除术后腹腔感染的临床研究.新疆医科大学, 2014.
18.	田夫, 向进见, 李明忠, 等.不同胰肠吻合方式的临床效果比较.世界华人消化杂志, 2009, 17(30):3160-3163.
19.	黄鹤光, 陈志耀, 刘多谋.胰肠吻合术式百年变迁.中国普外基础与临床杂志, 2013, 20(7):709-712.
20.	孙铁为, 刘军, 孙世波.胰肠端侧吻合应用桥袢式引流术临床应用效果.中国现代手术学杂志, 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.胰肠吻合技术的发展.外科理论与实践, 2013, 18(6):512-514.
23.	张宏炜, 王太洪.胰十二指肠切除术后不同胰肠吻合方式的效果与评价.肝胆外科杂志, 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, Dumitraşcu 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, Mužina Mišić D, Glavčić G.胰腺手术:演变及目前的个体化方案.中国普通外科杂志, 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.胰肠吻合新的理解-从机械连接到生物愈合.中国普通外科杂志, 2015, 24(9):1213-1215.
10. 李志鹏, 郑万仁, 李岩, 等.胰胃吻合术的应用及其并发症的研究进展.中国普外基础与临床杂志, 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. 杨媛媛, 黄鹤光, 陈燕昌, 等.胰腺空肠端侧套入式胰管空肠黏膜吻合200例经验.中国普外基础与临床杂志, 2013, 20(7):724-727.
13. 朱建平, 宿砚明, 黄庆荣, 等.套入式胰肠浆肌层U型贯穿缝合固定术-简易的胰肠吻合新方法.中国现代普通外科进展, 2015, 18(7):554-555.
14. 蒋奎荣, 钱栋, 苗毅.胰腺手术后胰瘘防治研究进展.中国实用外科杂志, 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. 张太平, 徐建威, 赵玉沛.胰腺癌根治术常见并发症与处理原则.中华普外科手术学杂志:电子版, 2013, 7(3):172-175.
17. 李刘诚.胰十二指肠切除术后腹腔感染的临床研究.新疆医科大学, 2014.
18. 田夫, 向进见, 李明忠, 等.不同胰肠吻合方式的临床效果比较.世界华人消化杂志, 2009, 17(30):3160-3163.
19. 黄鹤光, 陈志耀, 刘多谋.胰肠吻合术式百年变迁.中国普外基础与临床杂志, 2013, 20(7):709-712.
20. 孙铁为, 刘军, 孙世波.胰肠端侧吻合应用桥袢式引流术临床应用效果.中国现代手术学杂志, 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.胰肠吻合技术的发展.外科理论与实践, 2013, 18(6):512-514.
23. 张宏炜, 王太洪.胰十二指肠切除术后不同胰肠吻合方式的效果与评价.肝胆外科杂志, 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

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