Retrospective Study
Copyright ©The Author(s) 2015.
World J Gastrointest Surg. Nov 27, 2015; 7(11): 335-344
Published online Nov 27, 2015. doi: 10.4240/wjgs.v7.i11.335
Table 1 General information on patients in the single-layer anastomosis group
ItemMean valueStandard deviationMinimum valueMaximum value
Age (yr)58.8049.46638.00079.000
BMI (kg/m222.8662.75517.90029.400
Albumin (g/L)38.0393.89126.10045.000
Blood glucose (mol/L)6.4722.5403.96016.610
Total bilirubin (μmol/L)122.618122.2046.400412.600
Alkaline phosphatase (u/L)359.631258.62939.9001396.900
r-GT620.853522.4647.0002503.200
Operation time (min)220.05960.602135.000480.000
Pancreaticojejunal anastomosis time (min)17.9225.14511.00040.000
Amount of blood loss (mL)292.549146.940100.000800.000
Pancreatic duct diameter (mm)4.8632.3221.00012.000
Hospitalization time (d)25.6276.55115.00049.000
Postoperative hospitalization time (d)18.5885.2857.00033.000
Hospitalization expense (yuan)116787.66731900.92764874.000237762.000
Table 2 General information on patients in the double-layer anastomosis group
ItemMean valueStandard deviationMinimum valueMaximum value
Age (yr)58.02012.82018.00078.000
BMI (kg/m2)23.8583.27213.36032.690
Albumin (g/L)39.4804.18229.60050.000
Blood glucose (mol/L)6.4822.2284.12013.550
Total bilirubin (μmol/L)73.51078.2443.500313.000
Alkaline phosphatase (u/L)303.245268.28742.0001105.600
r-GT533.655631.9565.8002744.000
Operation time (min)379.41290.761210.000570.000
Pancreaticojejunal anastomosis time (min)31.3337.77616.00047.000
Amount of blood loss (mL)482.353293.90950.0001500.000
Pancreatic duct diameter (mm)3.9612.3621.50012.000
Hospitalization time (d)33.70615.89916.000105.000
Postoperative hospitalization time (d)26.37315.81511.000101.000
Hospitalization expense (yuan)162788.608129732.50084497.000968534.000
Table 3 Pathology data
Pathological typeNumber of cases
Distal bile duct adenocarcinoma29
Chronic inflammation at the end of the distal bile duct mucosa combined with moderate atypical dysplasia3
Villous adenoma at the end of distal bile duct mucosa and moderate-severe atypical dysplasia of some glands1
Ampullary adenocarcinoma14
Duodenal stromal tumors1
Adenocarcinoma of the descending duodenum3
Duodenal papilla adenocarcinoma20
Duodenal neuroendocrine tumors2
Tubulovillous adenoma of duodenal papilla with severe atypical dysplasia of some epithelia1
Duodenal papilla adenocarcinoma1
Chronic pancreatitis
Pancreatic head adenocarcinoma22
Solid-pseudopapillary tumor of pancreatic head1
Neuroendocrine tumor of pancreatic head2
Neuroendocrine carcinoma of pancreatic head1
Table 4 Comparison of patient data in the two groups, n
ItemSingle-layer anastomosis groupDouble-layer anastomosis groupP-value
Gender Female: 21 Female: 190.6850
Male: 30Male: 32
Age> 60 yr: 24> 60 yr: 250.8429
≤ 60 yr: 27 ≤ 60 yr: 26
HypertensionYes: 6Yes: 130.0750
No: 45No: 38
Diabetes mellitusYes: 10Yes: 40.0843
No: 41No: 47
Drinking historyYes: 14Yes: 160.6638
No: 37No: 35
Smoking historyYes: 13Yes: 140.8224
No: 38No: 37
Abdominal surgery historyYes: 5Yes: 80.3731
No: 46No: 43
Preoperative biliary drainageYes: 13Yes: 100.4772
No: 38No: 41
BMI> 25: 13> 25: 170.3847
≤ 25: 38 ≤ 25: 34
Total bilirubin> 171 μmol/L: 16> 171 μmol/L: 100.1728
≤ 171 μmol/L: 35 ≤ 171 μmol/L: 41
Serum albumin≥ 35 g/L: 40≥ 35 g/L: 470.0503
< 35 g/L: 11< 35 g/L: 4 cases
Blood glucose > 6.1 mmol/L: 19 > 6.1 mmol/L: 240.3161
≤ 6.1 mmol/L: 32  ≤ 6.1 mmol/L: 27
Disease composition Pancreatic head: 11Pancreatic head: 160.5418
Duodenum and papilla: 16Duodenum and papilla: 14
 Ampulla: 5 Ampulla: 5
 Distal bile duct: 19 Distal bile duct: 14
Surgical methodPD: 20PD: 160.4072
PPPD: 31PPPD: 35
Braun anastomosisYes: 5Yes: 20.2400
No: 46No: 49
Pancreatic textureSoft: 27Soft: 240.7918
Normal or mild fibrosis: 14 Hard: 10Normal or mild fibrosis: 17 Hard: 10
Pancreatic duct diameter  > 3 mm: 30> 3 mm: 260.4261
  ≤ 3 mm: 21 ≤ 3 mm: 25
Intraoperative blood transfusion  Yes: 4Yes: 10.3590
  No: 47No: 50
Table 5 Comparison of postoperative complications, n
ComplicationSingle-layer anastomosis groupDouble-layer anastomosis groupχ2P-value
Pancreatic fistulaYes: 13Yes: 3519.04630.0000
No: 38No: 16
Peritoneal catheterizationYes: 0Yes: 64.42710.0354
No: 51No: 45
Abdominal infectionYes: 1Yes: 119.44440.0021
No: 50No: 40
Total complicationsYes: 21Yes: 3710.23200.0014
No: 30No: 14
Table 6 Comparison of the incidence of pancreatic fistula in patients with different pancreatic textures in the two groups
Pancreatic textureSingle-layer anastomosis groupDouble-layer anastomosis groupχ2P-value
Soft10/2721/2413.57370.0002
Normal or mild fibrosis2/1410/170.0245
Hard1/104/100.3034
Table 7 Comparison of intraoperative and postoperative conditions in the single-layer anastomosis group and the double-layer anastomosis group
ItemSingle-layer anastomosis groupDouble-layer anastomosis groupMann-WhitneyP-value
Operation time (min)220.059 (± 60.602)379.412 (± 90.761)179.0000.000
Pancreaticojejunal anastomosis time (min)17.922 (± 5.145)31.333 (± 7.776)185.0000.000
Postoperative hospitalization time (d)18.588 (± 5.285)26.373 (± 15.815)854.5000.003
Total hospitalization time (d)25.627 (± 6.551)33.706 (± 15.899)841.0000.002
Hospitalization expense (yuan)116787.667 (± 31900.927)162788.608 (± 129732.500)800.0000.001