Study On The Application Of Modified Pancreaticojejunostomy In Laparoscopic Pancreaticoduodenectomy

Objective To explore the clinical value of modified pancreaticojejunostomy in laparoscopic pancreaticoduodenectomyMethods Retrospective analysis was performed on the case data of 77 patients with LPD in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Benbu Medical College from Jan.2016 to Apr.2020.The clinical data of modified pancreaticojejunostomy(modified group)combined with "Hong’s" pancreaticojejunostomy concept and "Chen’s" pancreatic intestinal suture technique and pancreatic duct jejunal mucosal anastomosis(traditional group)were compared.Results There was no significant difference in baseline data,peroperative bleeding,width of main pancreatic duct,pancreatic texture and postoperative pathology between the two groups(P>0.05).The incidence of postoperative pancreatic fistula in the modified group was 5.4%,significantly lower than that in the traditional group22.5%(P < 0.05).The operative time of the modified group was(374.7±50.8)min,and the pancreaticojejunostomy time was(28.1±5.4)min,both of which were significantly shorter than that of the traditional group(400.6±60.3)min and(43.4±7.0)min(P<0.05).The postoperative hospital stay in the improved group was(12.2±3.0)d,which was significantly shorter than that in the traditional group(15.7±3.3)d(P <0.05).There were no significant difference in the incidence of postoperative biochemical leakage,bile leakage,gastroparesis and bleeding events between the two groups(P > 0.05).Conclusion Compared with the method of pancreatic duct jejunal mucosal anastomosis,the modified method of pancreaticojejunostomy combined with the concept of "Hong’s" pancreaticojejunostomy and the technique of "Chen’s" pancreatic intestinal suture is relatively simple to operate,which can lower the incidence of postoperative pancreatic fistula,reduce the time of pancreaticojejunostomy,operation and postoperative hospital stay.This method is safe and effective in the application of LPD,and is worthy of further application in clinical practice.