Clinical Effect And Biomechanical Principle Of Pancreaticojejunostomy Reinforced With Pledget And Prolene

Objective To evaluate a new kind of pancreaticojejunostomy reinforced with pledget and prolene. Method 46 cases diagnosed with carcinoma of pancreatic head, ampulla, distal bile duct, duodenum and other periampullary carcinoma were randomly divided into 2 groups,24 patients in experimental group in which the pancreaticojejunostomy were reinforced with pledget and prolene, and 21 patients in control group without pledget. Comparing the date of the two groups including demographic and clinical pathological information, condition during operation and amylase of abdominal drainage fluid. Result The demographic and clinical pathological information in the two groups were not significantly different (P>0.05).The pancreatic remnant texture, procedures of pancreaticojejunostomy, operation time and bleeding volume were not significantly different (P>0.05).the time of pancreaticojejunostomy in the experimental group was longer than the control group with statistical difference(p=0.024). Postoperative complications, including biliary fistula, gastroparesis, operative incision problems, abdominal infection and intraabdominal bleeding, in the two groups were not significantly different (P>0.05). Occurrence rate of pancreatic leakage in the experimental group was lower than the control group(8.3%VS31.8%), but there was no significantly different (P>0.05). But stratified analyses showed that the rate of pancreatic leakage of experimental group in B group was significantly lower than the control group(p=0.046).The time of drainage tubes removed in the experimental group was shorter than the control group with statistical difference(p=0.038).There was no significantly different in the length of stay and post operation hospitalization duration (P>0.05). Conclusion The time of pancreaticojejunostomy reinforced with pledget was longer, but the rate of pancreatic leakage in B group was lower, and the time of drainage tubes removed was shorter, which may have clinical guiding significance in preventing pancreatic fistula in operation and deserved further study.Objective To analyze the biomechanical characteristic of the pledget used for the pancreaticojejunostomy. Method Cutting a pancreas into two sections with similar shape and properties. Suturing the rest pancreas with 4-0 prolene and the pledget in a U shape, the other pancreas only with 4-0 prolene in the same way. Measuring and analyzing the biomechanical date with the ElectropulsE1000.We totally test 21 groups. Result the maximum force in the pledge group is significantly higher than the control group(5.47±1.67Nvs3.72±1.36N). Conclusion The pledge can lighten the cutting damage and rise the maximum force.