Binding pancreaticojejunostomy: 150 consecutive cases without leakage |
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Authors: | Email author" target="_blank">Shu?You?PengEmail author Yi?Ping?Mou Yin?Bin?Liu Ying?Su Cheng?Hong?Peng Xiu?Jun?Cai Yu?Lian?Wu Lin?Hua?Zhou |
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Institution: | (1) Department of Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, 310009 Hangzhou, China;(2) Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China |
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Abstract: | The objective of this study was to verify the safety of a new technique termed "binding pancreaticojejunostomy" in a prospective
cohort study. Pancreaticojejunal anastomostic leakage is a major cause of morbidity and mortality after pancreaticoduodenectomy.
To prevent the development of pancreatic fistulas, we designed a special technique that we termed binding pancreaticojejunostomy.
Binding pancreaticojejunostomy entails binding 3 cm of the serosamuscular sheath of the jejunum to the intussuscepted pancreatic
stump. From January 1996 to May 2001, a total of 150 consecutive patients were treated with this type of pancreaticojejunostomy,
including typical pancreaticoduodenectomy in 120, hepatopancreaticoduodenectomy in 17, pylorus-preserving pancreaticoduodenectomy
in 10, and duodenal-preserving resection of the head of the pancreas in three. None of the patients developed pancreatic fistulas.
The overall morbidity was 31.3%. The following complications occurred: gastrointestinal bleeding in six, pulmonary infection
in 12, wound infection in 20, delayed gastric emptying in three, incision dehiscence in four, and hepatic insufficiency in
two. The mean postoperative hospital stay was 19.8 ± 5 days. Binding pancreaticojejunostomy is a safe, simple, and effective
technique.
Presented at the Fourth Americas Hepato-Pancreato-Biliary Congress, Miami, Florida, February 27-March 1, 2003. |
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Keywords: | Pancreas surgery pancreatic leakage pancreaticoduodenectomy pancreaticojejunostomy binding |
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