Application of Purse-String Invaginated Double-Layer Anastomosis of Pancreaticojejunal in Pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Zhiyuan , LIU Peng , YUAN Weisheng , ZHANG Hua , DIAO Tongjin , CHEN Jianfeng , GONG Lin

Department of Hepatobiliary Surgery, The 401st Hospital of PLA, Qingdao 266071, Shandong Province, China;

Corresponding author：

Keywords：

Pancreaticoduodenectomy; Purse-string invaginated; Pancreaticojejunostomy; Double-layer anastomosis; Pancreatic fistula

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Objective To evaluate the application of a surgical method in pancreaticoduodenectomy. Methods All the 211 cases of purse-string invaginated pancreaticojejunostomy performed from Dec.1985 to Dec.2007 were reviewed. Firstly, an accordant plastic tube was put and fastened in main pancreatic duct, and pancreas was ligated at 2-3 cm apart from the pancreatic stump to let secretin flow far away. Furthermore, invaginated pancreaticojejunostomy was performed to get closer between pancreas and jejunum. Results Pancreatic fistula and perioperative death didn’t occur among these 211 cases. The complications included 2 cases of incision dehiscence, 4 cases of biliary fistula and 1 case of scission of superior mesentric artery. Conclusion Purse-string invaginated double-layer anastomosis of pancreaticojejunal would be feasible for pancreaticoduodenectomy preventing pancreatic fistula.

Citation： WANG Zhiyuan,LIU Peng,YUAN Weisheng,ZHANG Hua,DIAO Tongjin,CHEN Jianfeng,GONG Lin. Application of Purse-String Invaginated Double-Layer Anastomosis of Pancreaticojejunal in Pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(12): 920-922. doi: Copy

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2.	Yeo CJ， Cameron JL， Sohn TA， et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s： pathology， complications， and outcomes [Ｊ]. Ann Surg， 1997； 226(3)∶ 248.
3.	Yeo CJ. Management of complications following pancreaticoduodenectomy [Ｊ]. Surg Clin North Am, 1995； 75(5)∶ 913.
4.	史卫海, 孙亚伟, 王人颢. 捆绑式胰肠吻合术的临床应用 [Ｊ]. 实用临床医药杂志, 2006； 10(3)∶ 63.
5.	Pen Shuyou, Mou Yi ping, Cai Xiujun, et al. Binding pancre-aticojejunostomy is a new technique to minimize leakage [Ｊ]. Am J Surg, 2002； 183（3）∶ 283.
6.	彭淑牖，刘颖斌. 胰十二指肠切除术胰肠吻合口漏的防治措施 [Ｊ]. 临床外科杂志， 2004； 12（4）∶ 199.
7.	刘颖斌，王建伟，方河清，　等. 捆绑式胰肠吻合术在胰十二指肠切除术中的应用 [Ｊ]. 中华医学杂志， 2004； 84（12）∶ 997.
8.	Shrikhande SV, Qureshi SS, Rajneesh N, et al. Pancreatic anastomoses after pancreaticoduodenectomy: do we need further studies? [Ｊ]. World J Surg, 2005； 29（12）∶1642.
9.	Duffas JP, Suc B, Msika S, et al. A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy [Ｊ]. Am J Surg, 2005; 189（6）∶ 720.
10.	Kotwall CA, Maxwell JG, Brinker CC, et al. National estimates of mortality rates for radical pancreaticoduodenectomy in 25　000 patients [Ｊ]. Ann Surg Oncol, 2002； 9（9）∶ 847.
11.	Bassi C, Falconi M, Molinari E, et al. Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial [Ｊ]. Surgery, 2003； 134(5)∶766.
12.	Calles-Vázquez MC, Usón JM, Viguera FJ, et al. Vascular closure stapler clips versus polypropylene sutures in end-to-end anastomoses of growing arteries and veins [Ｊ]. Ann Vasc Surg, 2005； 19(3)∶ 320.
13.	Grace PA， Pitt HA， Tompkins RK， et al. Decreased morbidity and mortality after pancreaticoduodenectomy [Ｊ]. Am J Surg, 1986； 151(1)∶ 141.
14.	Celis J, Berrospi F, Ruiz E, et al. Safe pancreaticojcjunostomy after Whipple procedure: modified technique [Ｊ]. J Surg Oncol, 2001； 76（2）∶ 138.
15.	Murr MM, Nagorney DM. An end-to-cnd pancrcaticojcjunostomy using a mcchanical pursc-string dcvice [Ｊ]. Am J Surg, 1999； 177（4）∶ 340.

1. 彭淑牖, 刘颖斌. 胰十二指肠切除术的改进与发展 [Ｊ]. 肝胆外科杂志， 2003； 11(6)∶ 401.
2. Yeo CJ， Cameron JL， Sohn TA， et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s： pathology， complications， and outcomes [Ｊ]. Ann Surg， 1997； 226(3)∶ 248.
3. Yeo CJ. Management of complications following pancreaticoduodenectomy [Ｊ]. Surg Clin North Am, 1995； 75(5)∶ 913.
4. 史卫海, 孙亚伟, 王人颢. 捆绑式胰肠吻合术的临床应用 [Ｊ]. 实用临床医药杂志, 2006； 10(3)∶ 63.
5. Pen Shuyou, Mou Yi ping, Cai Xiujun, et al. Binding pancre-aticojejunostomy is a new technique to minimize leakage [Ｊ]. Am J Surg, 2002； 183（3）∶ 283.
6. 彭淑牖，刘颖斌. 胰十二指肠切除术胰肠吻合口漏的防治措施 [Ｊ]. 临床外科杂志， 2004； 12（4）∶ 199.
7. 刘颖斌，王建伟，方河清，　等. 捆绑式胰肠吻合术在胰十二指肠切除术中的应用 [Ｊ]. 中华医学杂志， 2004； 84（12）∶ 997.
8. Shrikhande SV, Qureshi SS, Rajneesh N, et al. Pancreatic anastomoses after pancreaticoduodenectomy: do we need further studies? [Ｊ]. World J Surg, 2005； 29（12）∶1642.
9. Duffas JP, Suc B, Msika S, et al. A controlled randomized multicenter trial of pancreatogastrostomy or pancreatojejunostomy after pancreatoduodenectomy [Ｊ]. Am J Surg, 2005; 189（6）∶ 720.
10. Kotwall CA, Maxwell JG, Brinker CC, et al. National estimates of mortality rates for radical pancreaticoduodenectomy in 25　000 patients [Ｊ]. Ann Surg Oncol, 2002； 9（9）∶ 847.
11. Bassi C, Falconi M, Molinari E, et al. Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial [Ｊ]. Surgery, 2003； 134(5)∶766.
12. Calles-Vázquez MC, Usón JM, Viguera FJ, et al. Vascular closure stapler clips versus polypropylene sutures in end-to-end anastomoses of growing arteries and veins [Ｊ]. Ann Vasc Surg, 2005； 19(3)∶ 320.
13. Grace PA， Pitt HA， Tompkins RK， et al. Decreased morbidity and mortality after pancreaticoduodenectomy [Ｊ]. Am J Surg, 1986； 151(1)∶ 141.
14. Celis J, Berrospi F, Ruiz E, et al. Safe pancreaticojcjunostomy after Whipple procedure: modified technique [Ｊ]. J Surg Oncol, 2001； 76（2）∶ 138.
15. Murr MM, Nagorney DM. An end-to-cnd pancrcaticojcjunostomy using a mcchanical pursc-string dcvice [Ｊ]. Am J Surg, 1999； 177（4）∶ 340.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Purse-String Invaginated Double-Layer Anastomosis of Pancreaticojejunal in Pancreaticoduodenectomy

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