Comparative Study On Clinical Efficacy Of External And Inner Drainage Of Pancreatic Duct In Pancreaticoduodenectomy

Objective：By pancreatoduodenectomy postoperative pancreatic juicedrainage and external drainage effect, to understand the different drainagemethod and postoperative complications between the relationship, toprovide clinical basis for different operations.Methods： From December2014to December2012,68cases ofpancreatic resection of the No.1Hospital of Jilin University wereretrospectively analyzed. Male30cases, female38cases (male andfemale ratio1:1.3), aged37-70years, the average age of55.3years. Inpatients with resected specimens have all been confirmed by pathology,including31cases of pancreatic cancer,27cases of bile duct cancer at theend, periampullary carcinoma in7cases,2cases of duodenal papillacarcinoma, chronic pancreatitis in1case. Patients were not underwentpancreatic duct stent has no statistical significance in this study. Theincluded criteria:(1) the preoperative diagnosis of clear for pancreaticlesions (2) all into the group of patients underwent pancreatic duodenalresection and pathology.(3) age＜70.(4) the heart and lung function andblood coagulation index were normal.(5) after preoperative liver function index adjusted total bilirubin is less than or equal to200umol/l, albuminis more than30g/l. Exclusion criteria:(1) pancreatic space occupying nosignificant blood vessels.(2) age>70.(3) cardiac and pulmonaryfunction and abnormal coagulation index.(4) postoperative loss of access.(5) the occurrence and metastasis of pancreatic cancer (mainly liver).Results：The comparation of external and inner drainage of pancreaticduct in pancreaticoduodenectomy,operation time,amount of bleeding,fasting time,peri-operative complication rate was not statisticallysignificant(p>0.05),and the average hospitalization days in the internaldrainage group compared with external drainage group was significantlyshorter,with statistical significance(p<0.05).The relative factors of thepostoperative pancreatic fistula were high bilirubin,intra-operative bloodloss,pancreatic texture and pancreatic duct diameter(p<0.05),and werenot related to sex,age and operation time(p>0.05).Conclusions：1.External and inner drainage of pancreatic duct in pancreaticoduode-nectomy is effective, safe and feasible,especially in the relevant ind-exes of surgery.2.In the aspect of postoperative complications,therewere no obvious differences.3.The internal drainage of the pancreati-c duct is more convenient,the average length of hospital stay is sho-rtened,it can reduce the extra pain and the economic burden to thepatients, and it has some clinical value.4.The postoperative complic ations of pancreaticoduodenectomy were related to bilirubin levels and pancreatic texture, Drainage of pancreatic juice has nothing to do.