Application Of Pancreaticojejunal Single Layer Continuous Suture In Pancreaticoduodenectomy

ObjectiveTo investigate the clinical effects of Pancreaticoduodenectomy(PD)with continuous Pancreaticoduodenectomy by single layer suture method,and to provide evidence for clinical application.MethodsAdopt retrospective research method.Clinical data of 129 patients undergoing PD surgery in the First Affiliated Hospital of Zhengzhou University from September 2016 to October 2020 were collected.According to different pancreaticojejunostomy methods,the patients were divided into two groups:the pancreaticojejunostomy single layer continuous suture method group(improved group,75 cases)and the traditional end-to-side insertion pancreaticojejunostomy method group(traditional group,54 cases).Compare two groups of patients with preoperative general situation,the operation time,the pancreatic anastomosis time,intraoperative blood loss,postoperative hospital stay,postoperative complications,such as pancreatic leakage,bile leakage,bleeding,abdominal cavity infection,pulmonary infection and gastric emptying disorder,etc.)and reoperation rate and mortality following surgery.The measurement data of normal distribution were expressed x±s.The two independent samples t-test was used for those satisfying the homogeneity of variance,while the rank sum test was used for those not satisfying the homogeneity of variance.The statistical data were tested by χ2 test.ResultsAll 129 patients successfully completed the operation.The average time of pancreaticojejunostomy in the pancreaticojejunostomy group(modified group)was 19.01±2.43min,the operative time was 5.45±1.24h,and the intraoperative blood loss was 444.00±233.00ml.There were 4 cases of pancreatic leakage,1 case of hemorrhage,3 cases of bile leakage,4 cases of abdominal infection,1 case of gastric emptying disturbance,and 4 cases of pulmonary infection.One patient died due to sudden pulmonary embolism,and the rest recovered and discharged after symptomatic treatment,with an average postoperative hospital stay of 15.61±3.62 days.In the end-to-side pancreaticojejunostomy group(traditional group),the mean time of pancreaticojejunostomy was 22.21±3.32min,the operative time was 5.599±1.38h,and the intraoperative blood loss was 405.00±259.00mI,There were 5 cases of pancreatic leakage,2 cases of hemorrhage,2 cases of bile leakage,6 cases of abdominal infection,1 case of gastric emptied disorder,and 6 cases of pulmonary infection.Among them,2 patients underwent reoperation due to abdominal hemorrhage,and no postoperative death occurred.The mean postoperative hospital stay was 16.09±4.79 days.The time of pancreaticojejunostomy in the improved group was significantly shorter than that in the traditional group,and the difference was statistically significant(P<0.05).There were no significant differences in operative time,intraoperative blood loss,postoperative hospital stay,postoperative complications(such as pancreatic leakage,abdominal infection,bile leakage,bleeding,pulmonary infection,gastric emptying disorders,etc.)between the two groups(P>0.05).And there was no significant difference in the rate of reoperation and mortality between the two groups(P>0.05).ConclusionSingle continuous pancreaticojejunostomy has the advantages of simple operation,short time of pancreaticojejunostomy,relatively low technical difficulty,and no increase in postoperative complication rate,so it is a better choice in pancreaticojejunostomy.