Novel invagination procedure for pancreaticojejunostomy using double purse string sutures:A technical note  

作　　者：Jun Li He-Yuan Niu Xing-Kai Meng 

机构地区：[1]Department of Hepatobiliary,Pancreatic and Splenic Surgery,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010010,Inner Mongolia Autonomous Region,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第12期2792-2798,共7页世界胃肠外科杂志（英文版）（电子版）

基　　金：Supported by Major Project Funding of the Hohhot First Hospital,No.2022SYY(ZD)01;The Science And Technology Million Project Joint Project In Inner Mongolia Medical University,No.YKD2020KJBW(LH)027;Natural Science Foundation of Inner Mongolia Autonomous Region,No.2023MS08056;Breakthrough and Demonstration Promotion Of The Key Technological System For Minimally Invasive Treatment Of Biliary Tract Diseases,Inner Mongolia Autonomous Region Science and Technology Plan,No.2022YFSH0098.

摘　　要：BACKGROUND Postoperative pancreatic fistula(POPF)is one of the most serious complications after pancreaticoduodenectomy(PD),and the choice of pancreaticojejunostomy(PJ)is considered a key factor affecting the occurrence of POPF.Numerous anastomotic methods and their modifications have been proposed,and there is no method that can completely avoid the occurrence of POPF.Based on our team’s experience in pancreatic surgery and a review of relevant literature,we describe a novel invagination procedure for PJ using double purse string sutures,which has resulted in favourable outcomes.AIM To describe the precise procedural steps,technical details and clinical efficacy of the novel invagination procedure for PJ.METHODS This study adopted a single-arm retrospective cohort study methodology,involving a total of 65 consecutive patients who underwent PD with the novel invagination procedure for PJ,including the placement of a pancreatic stent,closure of the residual pancreatic end,and two layers of purse-string suturing.Baseline data included age,sex,body mass index(BMI),pancreatic texture,pancreatic duct diameter,operation time,and blood loss.Clinical outcomes included the operation time,blood loss,and incidence of POPF,postoperative haemorrhage,delayed gastric emptying,postoperative pulmonary infection,postoperative abdominal infection,and postoperative pulmonary infection.RESULTS The mean age of the patients was 59.12(±8.08)years.Forty males and 25 females were included,and the mean BMI was 21.61 kg/m^(2)(±2.74).A total of 41.53% of patients had a pancreatic duct diameter of 3 mm or less.The mean operation time was 263.83 min(±59.46),and the mean blood loss volume was 318.4 mL(±163.50).Following the surgical intervention,only three patients showed grade B POPF(4.62%),while no patients showed grade C POPF.Five patients(5/65,7.69%)were diagnosed with postoperative haemorrhage.Six patients(6/65,9.23%)experienced delayed gastric emptying.Four patients(4/65,6.15%)developed postoperative pulmonary infection,while an equ

关 键 词：Pancreatic anastomosis Pancreatojejunostomy Pancreatic fistula 

分 类 号：R656[医药卫生—外科学]