To Observe The Pancreatic Leakage、Scending Cholangitis And The Function Of Digestion And Absorption Afterisolated Pancreatic Juice And Bile Pancreaticoduodenectomy

Objective:To explore the effect of isolated pancreatic juice and bile pancreaticoduodenectomyand traditional pancreaticoduodenectomy on postoperative pancreatic leakage, ascendingcholangitis and the function of digestion and absorption.Methods:Retrospective analysis the clinical data of the67cases patients who underwentpancreaticoduodenectomy at the affiliated Hospital of Taishan Medcial University betweenJun.2000and Dec.2013. Depending on the different ways of digestive tract reconstructiondivided into isolated pancreatic juice and bile anastomosis group32cases, childanastomosis group35cases. Compare the operation time, intraoperative blood loss, averagepostoperative anal exhaust time,average days of hospitalization, pancreatic fistula rate,ascending cholangitis rate and the function of digestion and absorption after operationbetween two group.Results:67pancreaticoduodenectomy Patients, there were15cases of Postoperativecomplications(22.4%),4cases of pancreatic leakage(6.0%);1case of mortality(1.5%).Other complications including biliary fistula2, intra-abdominal hemorrhage1, abdominalinfection3, ascending cholangitis3, lung infection1, delayed gastric emptying1. TheClass B pancreatic leakage rate of child anastomosis group was10.3%(4/35), The Class Bpancreatic leakage rate of isolated pancreatic juice and bile anastomosis group was0%(0/32). There was significant differences in two groups(P<0.05). The average operation time was statistically significant difference between the two groups(P<0.05). The averageintraoperative blood loss, average postoperative anal exhaust time, average days ofhospitalization was no statistically significant difference between the two groups(P>0.05).The ascending cholangitis rate of child anastomosis group was2.9%(1/35), the ascendingcholangitis rate of isolated pancreatic juice and bile anastomosis group was6.3%(2/32).There was no significant differences in two groups(P>0.05). The function of digestion andabsorption after operation was no statistically significant difference between the twogroups(P>0.05).Conclusion:Through this research, compare isolated pancreatic juice and bile anastomosisgroup and child anastomosis group what were used in67cases ofPancreaticoduodenectomy, we came to a conclusion that the solation pancreatic juice andbile anastomosis increase a Braun anastomosis than child anastomosis, although theoperation time was extended, but can effectively reduce the incidence of pancreatic leakage.The average intraoperative blood loss, average postoperative anal exhaust time, averagedays of hospitalization, ascending cholangitis rate and function of digestion and absorptionafter operation was no statistically significant difference between the two groups.