Current Status of Prevention of Pancreatic Fistula after Pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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Department of Surgery, The Second Affiliated Hospital, Zhejiang University of Medical College, Hangzhou 310031;

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PancreaticoduodenectomyPancreatic fistulaPrevention

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ObjectiveTo evaluate the various methods in prevention of pancreatic fistula after pancreaticoduodenectomy.MethodsThe literatures over the years related to prevention of pancreatic fistula were reviewed.ResultsManagement of the pancreatic stump following pancreaticoduodenectomy played the most important role in preventing pancreatic fistula. None of the methods of pancreatic stump had proved to be perfect in preventing pancreatic fistula, though pancreaticojejunostomy was the most widely practiced reconstruct strategy in varieties of option. For pancreaticojejunostomy and pancreaticogastrostomy, the rate of this complication was 12.3% and 11.1%,respectively. In recent years, a new procedure, bindingup pancreaticoduodenectomy, had shown a promise and excellent results in prevention of pancreatic fistula, the rate of fistula was 0 for consecutive 100 cases after pancreaticoduodenectomy.ConclusionBindingup pancreaticojejunostomy have a definite effect to avoid pancreatic fistula and be worthy of being recommended

Citation： LIU Yingbin,BAI Mingdong,PENG Shuyong,et al.. Current Status of Prevention of Pancreatic Fistula after Pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(3): 215-217. doi: Copy

1.	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.
2.	Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(5)∶580.
3.	Staley CA, Lee JE, Cleary KR, et al. Preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for adenocarcinoma of pancreatic head [Ｊ]. Am J Surg, 1996; 171(1)∶118.
4.	Matsumoto Y, Fujii H, Miura K, et al. Successful pancreatojejunal anastomosis for pancreaticoduodenectomy [Ｊ]. Surg Gynecol Obstet, 1992; 175(5)∶555.
5.	Marcus ST, Cohen H, Ranson JHC, et al. Optimal management of the pancreatic remnant after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 221(6)∶635.
6.	Tsuji M, Kimura H, Konixhi K, et al. Management of continuous anastomosis of pancreatic duct and jejunal mucous after pancreaticoduodenectomy: historical study of 300 patients [Ｊ]. Surgery, 1998; 123(6)∶617.
7.	Bottger TC, Juniner T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: critical analysis of 221 resections [Ｊ]. World J Surg, 1999; 23(2)∶164.
8.	Bottger TC, Juniner T. Treatment of tumors of the pancreatic head with suspected but unproved malignancy: is a nihilistic approach justified [Ｊ]. World J Surg, 1999; 23(2)∶158.
9.	Berberat PO, Friess H, Kleeff J, et al. Prevention and treatment of complications in pancreatic cancer surgery [Ｊ]. Dig Surg, 1999; 16(4)∶327.
10.	Baumel H, Huguier JC, Manderscheid JM. Results of resection of cancer of exocrine pancreas: a study from the French association of surgery [Ｊ]. Br J Surg, 1994; 81(1)∶102.
11.	Sauvanet A, Belghiti J. Prevention of pancreatic fistula after cephalic duodenopancreatectomy [Ｊ]. Ann Chir, 1999; 53(7)∶612.
12.	Bartoli FG, Amonet GB, Ravera G, et al. Pancreatic fistula and relative mortality in malignant disease after pancreaticoduodenectomy. Review and statistical meta analysis regarding 15 years of literature [Ｊ]. Anticancer Res, 1991; 65(11)∶1831.
13.	张志伟，蔡中瑞，何柏威，等. 胰十二指肠切除术后并发胰瘘的预防 [Ｊ]. 中华外科杂志，1997； 35（3）∶192.
14.	杜春渊，汪俊堂. 空肠浆肌袖与胰腺端端吻合防止胰十二指肠切除术后胰瘘技术 [Ｊ]. 当代医师杂志， 1996； 1（5）∶50.
15.	岳茂兴，李学彪，张圭显. 胰空肠套入荷包缝合完全胰液外引流术预防胰十二指肠切除术后胰瘘 [Ｊ]. 中华外科杂志， 1997； 35（6）∶ 370.
16.	彭淑牖，吴育连，彭承宏，等. 捆绑式胰肠吻合术（附28例报告） [Ｊ]. 中华外科杂志， 1997； 35（3）∶158.
17.	彭淑牖，牟一平，江献川，等. 胰断端空肠浆肌鞘内套入吻合术（附11例报告） [Ｊ]. 中国实用外科杂志，1996； 16（10）∶12.
18.	彭淑牖，吴育连，彭承宏，等. 一种确保不发生胰瘘的术式——捆绑式胰肠吻合术 [Ｊ]. 普外基础与临床杂志，1997； 4（4）∶ 242.
19.	Grace PA, Pitt HA, Tompkins RK, et al. Decreased mobility and mortality after pancreaticoduodenectomy [Ｊ]. Am J Surg, 1986; 151(2)∶141.
20.	Ohwada S, Iwazaki S, Nakamura S, et al. Pancreaticojejunostomysecuring technique: ducttomucous anastomosis by continuous running suture and parachuting using no filament absorbed thread [Ｊ]. J Am Coll Surg, 1997; 185(2)∶190.
21.	赵玉沛，蔡力行，钟守先. 胰管空肠残端套入法预防Whipple术后胰瘘发生 [Ｊ].中华外科杂志，1993； 31（6）∶360.
22.	Delcore R, Thomas JH, Pierce GE, et al. Pancreatogastrostomy: a safe drainage procedure after pancreaticoduodenectomy [Ｊ]. Surgery, 1990; 108(6)∶641.
23.	Sikora SS, Posenr MC. Management of the pancreatic stump following pancreaticoduodenectomy [Ｊ]. Br J Surg, 1995; 82(12)∶1590.
24.	DiCarlo V, Chiesa K, Pontiroli AE, et al. Pancreaticoduodenectomy with occlusion of the residual stump by neoprene injection [Ｊ]. World J Surg, 1989: 13(11)∶1102.
25.	Tashior S, Murata E, Hiraoka T, et al. New technique for pancreaticojejunostomy using a biological adhesive [Ｊ]. Br J Surg, 1987; 74(4)∶392.
26.	Brooks JR, Brooks DC, Levine JD, et al. Total pancreatectomy for duct cell carcinoma of the pancreas [Ｊ]. Ann Surg, 1989; 209(4)∶405.
27.	Sarr MG, Behrns KE, Van heerden JA, et al. Total pancreatectomy: an objective analysis of its use in pancreatic cancer [Ｊ]. Hepatogastroenterology, 1993; 40(4)∶418.
28.	Pederzoli P, Bassi C, Falconi M, et al. Efficacy of octreotied in the prevention of complications of elective pancreatic surgery [Ｊ]. Br J Surg, 1994; 81(3)∶265.
29.	Montorsi M, Zago M, Mosca F, et al. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized trial [Ｊ]. Surgery, 1995; 117(1)∶26.
30.	Lowy AM, Lee JF, Pisters PWT. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease [Ｊ]. Ann Surg, 1997; 226(6)∶632.

1. 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.
2. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(5)∶580.
3. Staley CA, Lee JE, Cleary KR, et al. Preoperative chemoradiation, pancreaticoduodenectomy, and intraoperative radiation therapy for adenocarcinoma of pancreatic head [Ｊ]. Am J Surg, 1996; 171(1)∶118.
4. Matsumoto Y, Fujii H, Miura K, et al. Successful pancreatojejunal anastomosis for pancreaticoduodenectomy [Ｊ]. Surg Gynecol Obstet, 1992; 175(5)∶555.
5. Marcus ST, Cohen H, Ranson JHC, et al. Optimal management of the pancreatic remnant after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 221(6)∶635.
6. Tsuji M, Kimura H, Konixhi K, et al. Management of continuous anastomosis of pancreatic duct and jejunal mucous after pancreaticoduodenectomy: historical study of 300 patients [Ｊ]. Surgery, 1998; 123(6)∶617.
7. Bottger TC, Juniner T. Factors influencing morbidity and mortality after pancreaticoduodenectomy: critical analysis of 221 resections [Ｊ]. World J Surg, 1999; 23(2)∶164.
8. Bottger TC, Juniner T. Treatment of tumors of the pancreatic head with suspected but unproved malignancy: is a nihilistic approach justified [Ｊ]. World J Surg, 1999; 23(2)∶158.
9. Berberat PO, Friess H, Kleeff J, et al. Prevention and treatment of complications in pancreatic cancer surgery [Ｊ]. Dig Surg, 1999; 16(4)∶327.
10. Baumel H, Huguier JC, Manderscheid JM. Results of resection of cancer of exocrine pancreas: a study from the French association of surgery [Ｊ]. Br J Surg, 1994; 81(1)∶102.
11. Sauvanet A, Belghiti J. Prevention of pancreatic fistula after cephalic duodenopancreatectomy [Ｊ]. Ann Chir, 1999; 53(7)∶612.
12. Bartoli FG, Amonet GB, Ravera G, et al. Pancreatic fistula and relative mortality in malignant disease after pancreaticoduodenectomy. Review and statistical meta analysis regarding 15 years of literature [Ｊ]. Anticancer Res, 1991; 65(11)∶1831.
13. 张志伟，蔡中瑞，何柏威，等. 胰十二指肠切除术后并发胰瘘的预防 [Ｊ]. 中华外科杂志，1997； 35（3）∶192.
14. 杜春渊，汪俊堂. 空肠浆肌袖与胰腺端端吻合防止胰十二指肠切除术后胰瘘技术 [Ｊ]. 当代医师杂志， 1996； 1（5）∶50.
15. 岳茂兴，李学彪，张圭显. 胰空肠套入荷包缝合完全胰液外引流术预防胰十二指肠切除术后胰瘘 [Ｊ]. 中华外科杂志， 1997； 35（6）∶ 370.
16. 彭淑牖，吴育连，彭承宏，等. 捆绑式胰肠吻合术（附28例报告） [Ｊ]. 中华外科杂志， 1997； 35（3）∶158.
17. 彭淑牖，牟一平，江献川，等. 胰断端空肠浆肌鞘内套入吻合术（附11例报告） [Ｊ]. 中国实用外科杂志，1996； 16（10）∶12.
18. 彭淑牖，吴育连，彭承宏，等. 一种确保不发生胰瘘的术式——捆绑式胰肠吻合术 [Ｊ]. 普外基础与临床杂志，1997； 4（4）∶ 242.
19. Grace PA, Pitt HA, Tompkins RK, et al. Decreased mobility and mortality after pancreaticoduodenectomy [Ｊ]. Am J Surg, 1986; 151(2)∶141.
20. Ohwada S, Iwazaki S, Nakamura S, et al. Pancreaticojejunostomysecuring technique: ducttomucous anastomosis by continuous running suture and parachuting using no filament absorbed thread [Ｊ]. J Am Coll Surg, 1997; 185(2)∶190.
21. 赵玉沛，蔡力行，钟守先. 胰管空肠残端套入法预防Whipple术后胰瘘发生 [Ｊ].中华外科杂志，1993； 31（6）∶360.
22. Delcore R, Thomas JH, Pierce GE, et al. Pancreatogastrostomy: a safe drainage procedure after pancreaticoduodenectomy [Ｊ]. Surgery, 1990; 108(6)∶641.
23. Sikora SS, Posenr MC. Management of the pancreatic stump following pancreaticoduodenectomy [Ｊ]. Br J Surg, 1995; 82(12)∶1590.
24. DiCarlo V, Chiesa K, Pontiroli AE, et al. Pancreaticoduodenectomy with occlusion of the residual stump by neoprene injection [Ｊ]. World J Surg, 1989: 13(11)∶1102.
25. Tashior S, Murata E, Hiraoka T, et al. New technique for pancreaticojejunostomy using a biological adhesive [Ｊ]. Br J Surg, 1987; 74(4)∶392.
26. Brooks JR, Brooks DC, Levine JD, et al. Total pancreatectomy for duct cell carcinoma of the pancreas [Ｊ]. Ann Surg, 1989; 209(4)∶405.
27. Sarr MG, Behrns KE, Van heerden JA, et al. Total pancreatectomy: an objective analysis of its use in pancreatic cancer [Ｊ]. Hepatogastroenterology, 1993; 40(4)∶418.
28. Pederzoli P, Bassi C, Falconi M, et al. Efficacy of octreotied in the prevention of complications of elective pancreatic surgery [Ｊ]. Br J Surg, 1994; 81(3)∶265.
29. Montorsi M, Zago M, Mosca F, et al. Efficacy of octreotide in the prevention of pancreatic fistula after elective pancreatic resections: a prospective, controlled, randomized trial [Ｊ]. Surgery, 1995; 117(1)∶26.
30. Lowy AM, Lee JF, Pisters PWT. Prospective, randomized trial of octreotide to prevent pancreatic fistula after pancreaticoduodenectomy for malignant disease [Ｊ]. Ann Surg, 1997; 226(6)∶632.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Current Status of Prevention of Pancreatic Fistula after Pancreaticoduodenectomy

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