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2007 2

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A novel method for reconstruction in laparoscopic pancreaticoduodenectomy: an experience of 13 cases

LU Bangyu, HUANG Yubin, CAI Xiaoyong, HUANG Fei, LU Wenqi, XU Jing, LIU Zujun, YAN Yihe, LI Jianjun, LI Jie

《医学前沿（英文）》 2007年第1卷第4期页码 369-372 doi: 10.1007/s11684-007-0071-x

摘要： Laparoscopic pancreaticoduodenectomy (LPD) is a challenging operation to general surgeon. Up to date, only about 135 cases have been reported, 16 cases in China, 119 cases outside China. The reconstruction of alimentary system is a key procedure to ensure success of the whole surgery. It is worth investigating the methods of reconstruction in LPD. A retrospective study is made to investigate the methods of reconstruction in LPD. We analyze 13 cases of LPD performed in our center. Child s or modified Child s method was used to make the reconstruction in our practice. We tried three methods to make the anastomosis of pancreaticojejunostomy, including end-to-end dunking binding pancreaticojejunostomy in two cases, end-to-end dunking pancreaticojejunostomy using interrupted suture in two cases, and duct-to-jejunal end-to-side embedding pancreaticojejunostomy in nine cases. The clinical data was collected and analyzed. Three of four patients, who underwent end-to-end pancreaticojejunostomy, had a little pancreatic leakage, especially in the first case. None of other nine patients, who underwent duct-to-jejunal end-to-side embedding pancreaticojejunostomy, was detected to have pancreatic leakage, and the operating time of these nine cases was less than other four cases. Duct-to-jejunal end-to-side embedding pancreaticojejunostomy is a safe and efficient method of reconstruction in LPD.

关键词： alimentary dunking pancreaticojejunostomy challenging operation anastomosis success

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Effect of end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture in pancreatic

ZHANG Xuewen, XUAN Wei, JIANG Tao, JI Degang, YANG Yongsheng, ZHANG Dan, XIE Yingjun, MENG Zihui, ZHAO Jisheng

《医学前沿（英文）》 2007年第1卷第1期页码 46-48 doi: 10.1007/s11684-007-0009-3

摘要： The aim of this paper is to summarize the methods of pancreaticojejunostomy in the pancreatic operation and to study the safety and feasibility of a new operative method called end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture to prevent fistula of pancreaticojejunostomy. Eight-three patients with pancreaticoduodenectomy in the 3rd Hospital, Jilin University from 2001 January to 2006 April were reviewed. The incidences of pancreatic fistula with different types of pancreaticojejunostomy were compared. The overall incidence rate of pancreatic fistula was 26.5% (22/83). No pancreatic fistula occurred in end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture. The incidence rate of the fistula following end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture was significantly lower than that of traditional end-to-end pancreaticojejunostomy [40%, (10/25), <0.01] and end-to-side pancreaticojejunostomy [27.3%, (12/44), <0.05], but no significant difference (>0.05) between traditional end-to-end pancreaticojejunostomy and end-to-side pancreaticojejunostomy was discovered. End-to-end invagination pancreaticojejunostomy with circle discontinuous U suture has a definite effect on avoiding pancreatic fistula following pancreaticojejunostomy and is worth being recommended. But the cases were limited, so this method would still need to be observed and confirmed further in the future.