Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2022; 10(26): 9276-9284
Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9276
One-half layer pancreaticojejunostomy with the rear wall of the pancreas reinforced: A valuable anastomosis technique
Jin-Ping Wei, Sheng Tai, Zhi-Lei Su
Jin-Ping Wei, Department of General Surgery, Beijing Chuiyangliu Hospital, Beijing 100022, China
Sheng Tai, Zhi-Lei Su, Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, Heilongjiang Province, China
Author contributions: Wei JP and Tai S contributed equally to this work; Tai S designed the research study; Wei JP, Tai S, and Su ZL performed the research; Wei JP and Su ZL contributed new reagents and analytic tools; Wei JP analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Supported by the Jie-Ping Wu Foundation for Clinical Scientific Research, No. 320.6750.1245.
Institutional review board statement: The study was approved by the Medical Ethics Committee of Harbin Medical University (No. HMUIRB20160006).
Informed consent statement: All patients or their next of kin provided informed consent for surgery.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No other data available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sheng Tai, MD, PhD, Chief Doctor, Department of Hepatopancreatobiliary Surgery, The Second Affiliated Hospital of Harbin Medical University, No. 46 Xuefu Road, Nangang, Harbin 150086, Heilongjiang Province, China. taisheng1973@yeah.net
Received: December 25, 2021
Peer-review started: December 25, 2021
First decision: March 12, 2022
Revised: March 26, 2022
Accepted: August 5, 2022
Article in press: August 5, 2022
Published online: September 16, 2022
Abstract
BACKGROUND

Postoperative pancreatic fistula (POPF) is one of the most common and serious complications after pancreaticoduodenectomy (PD). To effectively reduce the incidence of POPF, we designed a new type of pancreaticojejunostomy (PJ), which was termed one-half layer PJ with the rear wall of the pancreas reinforced.

AIM

To explore the clinical application value of this new technique.

METHODS

We compared 62 patients who had undergone PD by either the traditional duct-to-mucosa anastomoses or the new one-half layer PJ with the rear wall of the pancreas reinforced method at our hospital from May 2015 to September 2019. All 62 patients were operated by the same surgeon experienced in both procedures. We retrospectively analyzed patient characteristics, perioperative outcomes, and surgical results.

RESULTS

There was no significant difference between the two groups in basic information except the postoperative hospital stays, 14.7 ± 5.4 d in the traditional duct-to-mucosa anastomoses group and 12.0 ± 4.2 d in the one-half layer PJ group (P = 0.042). In terms of postoperative complications, the one-half layer PJ group had a lower rate of POPF than the traditional group. The overall number of cases with POPF was 8 (24.2%) in the traditional group and 2 (6.9%) in the one-half layer group (P = 0.017). Additionally, the rate of grades B and C POPF was lower in the one-half layer group (3.4%) compared with that (12.1%) in the traditional group (P = 0.010). One patient died due to hemorrhage caused by severe pancreatic fistula in the traditional group.

CONCLUSION

One-half layer PJ with the rear wall of the pancreas reinforced is a safe and feasible procedure that can successfully reduce the rate of POPF. It may be a promising technique for PJ after PD.

Keywords: Pancreaticoduodenectomy, Pancreaticojejunostomy, Pancreatic fistula, One-half layer, New technique, Postoperative complications

Core Tip: Postoperative pancreatic fistula (POPF) is one of the most common and serious complications after pancreaticoduodenectomy. To effectively reduce the incidence of POPF, we designed a new type of pancreaticojejunostomy (PJ). The technique that we introduce in this paper is a very new kind of PJ. Our research confirmed that this new technique is simple, safe, and easy to operate, and it can effectively reduce the occurrence of POPF.