Effects Of Prophylactic Continuous Irritation-suction Around The Anastomosis Of Pancreaticojejunostomy On The Incidence Of Postoperative Pancreatic Fistula After Pancreaticoduodenectomy

Objective To investigate the effect of prophylactic continuous irritation-suction around the anastomosis of pancreaticojejunostomy on the incidence of postoperative pancreatic fistula after pancreaticoduodenectomy,to observe the therapeutic effect of the postoperative drainage tube management.MethodsA total of 107 patients were randomly divided into the control group and the experimental group,respectively using different methods of postoperative drainage tube management,for a prospective and controlled study.During the operation,an irrigation-suction tube was placed below left liver,superiorly and posteriorly to the anastomosis of pancreaticojejunostomy,defined as PJ drainage.After the operation,In experimental group,PJ drainage was persistently irrigated with 0.9% saline solution under closed negative pressure.The irrigation-suction lasted for 5 days.In control group,PJ drainage was as routine gravity drainage.Postoperative statistics were performed on the occurrence of pancreatic fistula and related complications,length of stay,and hospitalization expense.ResultsThere was no significant difference in the incidence of postoperative pancreatic fistula between the experimental group and the control group(17.3% VS 14.5%,p=0.696).There was no significant difference between the two groups in the incidence of these postoperative complications including biliary leakage,chyle leak,delayed gastric emptying.There was no statistically significant difference in drainage tube removal time,postoperative hospitalization days,hospitalization expenses.However,the incidence of intra-abdominal infection in the experimental group(7.7% VS 23.6%,p=0.047)was significantly lower than that in the control group.Further analysis results also show that when the main pancreatic duct diameter < 3 mm,the experimental group and control group in the incidence of postoperative CR-POPF(9.5% VS 16.0%,p=0.516)was no statistically significant difference.However,the length of postoperative hospitalization days,duration of removal of the PJ drainage,hospitalization expenses and incidence of intra-abdominal infection in the experimental group were better than those in the control group.ConclusionAfter pancreaticoduodenectomy,prophylactic continuous irritation-suction around the anastomosis of pancreaticojejunostomy can effectively reduce the incidence of intra-abdominal infection.In addition,for patients with the diameter of the main pancreatic duct less than 3mm,this drainage tube management method can effectively reduce the risk of pancreatic fistula after PD,shorten the recovery period,and benefit the patients.