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©The Author(s) 2019.
World J Gastroenterol. May 28, 2019; 25(20): 2514-2523
Published online May 28, 2019. doi: 10.3748/wjg.v25.i20.2514
Published online May 28, 2019. doi: 10.3748/wjg.v25.i20.2514
Table 1 Demographic and clinical characteristics of 291 patients
Blumgart anastomosis | Embedded anastomosis | P-value | |
No. of patients | 201 | 90 | |
Age, mean ± SE, yr | 53.28 ± 1.35 | 54.54 ± 1.81 | 0.584 |
Sex (male/female) | 109/92 | 41/49 | 0.172 |
Past medical history, n (%) | |||
Diabetes mellitus | 40 (19.9) | 20 (22.2) | 0.652 |
Cholecystolithiasis | 39 (19.4) | 20 (22.2) | 0.582 |
Cardiovascular disease | 50 (24.9) | 28 (31.1) | 0.269 |
Personal medical history, n (%) | |||
Smoking | 97 (48.3) | 50 (55.6) | 0.251 |
Drinking | 53 (26.4) | 25 (27.8) | 0.803 |
Preoperative lab test, mean ± SE | |||
Serum albumin, g/L | 41.82 ± 1.54 | 40.50 ± 1.41 | 0.552 |
Total bilirubin, μmol/L | 69.53 ± 13.8 | 54.87 ± 15.1 | 0.510 |
Direct bilirubin, μmol/L | 49.66 ± 11.0 | 41.53 ± 13.0 | 0.653 |
Cancer antigen 19-9, U/L | 239.6 ± 41.9 | 248.5 ± 53.9 | 0.896 |
Diameter of the mass, mean ± SE, cm | 3.46 ± 0.23 | 3.06 ± 0.29 | 0.314 |
Type of neoplasms, n (%) | |||
Pancreatic ductal adenocarcinoma | 137 (68.2) | 65 (72.2) | 0.489 |
Intraductal papillary mucinous neoplasm | 6 (3.0) | 2 (2.2) | 0.714 |
Cystic lesion | 10 (4.9) | 4 (4.4) | 0.846 |
Neuroendocrine tumor | 6 (3.0) | 3 (3.3) | 0.875 |
Solid-pseudopapillary tumor | 13 (6.5) | 6 (6.7) | 0.950 |
Pancreatitis | 10 (4.9) | 5 (5.6) | 0.837 |
Others | 19 (9.5) | 5 (5.6) | 0.266 |
Table 2 Intraoperative and perioperative statuses
Blumgart anastomosis | Embedded anastomosis | P-value | ||
Intraoperative results, n (%) | ||||
No. of patients | 201 | 90 | ||
Operation time, mean ± SEM, min | 343.5 ± 23.0 | 450.0 ± 40.1 | 0.028 | |
Blood loss, mean ± SE, mL | 641.4 ± 65.9 | 866.7 ± 102 | 0.073 | |
Blood transfusion, n (%) | 76 (37.8) | 44 (48.9) | 0.077 | |
Diameter of the pancreatic duct, mean ± SE, mm | 5.50 ± 0.79 | 4.85 ± 0.15 | 0.687 | |
Insertion of pancreatic duct stent, n (%) | 96 (47.8) | 33 (36.7) | 0.079 | |
Texture of the pancreas | Soft | 33 (16.4) | 15 (16.7) | 0.958 |
Tough | 117 (58.2) | 45 (50.0) | 0.194 | |
Hard | 51 (25.4) | 30 (33.3) | 0.163 | |
Postoperative results, n (%) | ||||
Mortality | 1 (0.5) | 1 (1.1) | 0.560 | |
Reoperation | 12 (6.0) | 11 (12.2) | 0.068 | |
Overall complications (≥Clavien grade 3) | 24 (11.9) | 24 (26.7) | 0.002 | |
Duration of PJ drainage tube placement, mean ± SE, d | 12.7 ± 0.9 | 17.4 ± 1.8 | 0.031 | |
Postoperative pancreatic fistula | None | 105 (52.2) | 40 (44.4) | 0.220 |
Biochemical leak | 77 (38.3) | 31 (34.4) | 0.530 | |
Grade B | 16 (8.0) | 14 (15.6) | 0.049 | |
Grade C | 3 (1.5) | 5 (5.6) | 0.050 | |
Abdominal bleeding | 14 (7.0) | 11 (12.2) | 0.140 | |
Intraperitoneal infections | 12 (6.0) | 7 (7.8) | 0.566 | |
Biliary fistula | 5 (2.5) | 4 (4.4) | 0.375 | |
Delayed gastric emptying (≥ISGPS grade B) | 34 (16.9) | 20 (22.2) | 0.284 | |
Others | 21 (10.5) | 12 (13.3) | 0.475 | |
Postoperative hospitalization duration, mean ± SE, d | 21.9 ± 1.3 | 28.9 ± 1.3 | 0.020 |
Table 3 Information of the patients with postoperative pancreatic fistula
POPF (<ISGPS grade B) | POPF (≥ISGPS grade B) | P-value | |
No. of patients | 253 | 38 | |
Age, mean ± SE, yr | 53.30 ± 1.16 | 54.79 ± 3.22 | 0.640 |
Sex (male/female) | 131/122 | 19/19 | 0.839 |
Body mass index, mean ± SE, kg/m2 | 23.13 ± 0.40 | 23.84 ± 0.87 | 0.486 |
Blumgart anastomosis, n (%) | 182 (71.9) | 19 (50.0) | 0.006 |
Hard pancreas, n (%) | 75 (29.7) | 6 (15.8) | 0.076 |
Pancreatic malignancy, n (%) | 179 (70.8) | 23 (60.5) | 0.204 |
Pancreatitis, n (%) | 14 (5.5) | 1 (2.6) | 0.452 |
Diameter of the pancreatic duct, mean ± SE, mm | 5.42 ± 0.35 | 4.65 ± 0.30 | 0.131 |
Intraoperative blood loss, mean ± SE, mL | 681.6 ± 70.8 | 819.1 ± 140 | 0.347 |
- Citation: Li YT, Zhang HY, Xing C, Ding C, Wu WM, Liao Q, Zhang TP, Zhao YP, Dai MH. Effect of Blumgart anastomosis in reducing the incidence rate of pancreatic fistula after pancreatoduodenectomy. World J Gastroenterol 2019; 25(20): 2514-2523
- URL: https://www.wjgnet.com/1007-9327/full/v25/i20/2514.htm
- DOI: https://dx.doi.org/10.3748/wjg.v25.i20.2514