A new feasible technique of mesh-reinforced pancreatojejunostomy and pancreatogastrostomy: retrospective analysis of 61 cases

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• 作者：Wang Xianfa (1)
  Xin Ying (1)
  Pan Junhai (1)
  Zhang Nengyun (1)
  Zhou Wei (1)
  
• 关键词：Pancreatogastrostomy ; Pancreatojejunostomy ; Mesh
• 刊名：World Journal of Surgical Oncology
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：10
• 期：1
• 全文大小：553KB
• 参考文献：1. Buchler MW, Friess H, Wagner M, Kulli C, Wagener V, Z’Graggen K: Pancreatic fistula after pancreatic head resection. / Br J Surg 2000, 87:883-89. CrossRef
  2. Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M: Postoperative pancreatic fistula: an international study group (ISGPF) definition. / Surgery 2005, 138:8-3. CrossRef
  3. Hosotani R, Doi R, Imamura M: Duct-to-mucosa pancreaticojejunostomy reduces the risk of pancreatic leakage after pancreatoduodenectomy. / World J Surg 2002, 26:99-04. CrossRef
  4. Bassi C, Falconi M, Molinari E, Mantovani W, Butturini G, Gumbs AA, Salvia R, Pederzoli P: Duct-to-mucosa versus end-to-side pancreaticojejunostomy reconstruction after pancreaticoduodenectomy: results of a prospective randomized trial. / Surgery 2003, 134:766-71. CrossRef
  5. Stojadinovic A, Brooks A, Hoos A, Jaques DP, Conlon KC, Brennan MF: An evidence-based approach to the surgical management of resectable pancreatic adenocarcinoma. / J Am Coll Surg 2003, 196:954-64. CrossRef
  6. Huang DY, Wang XF, Zhou W, Xin Y, Mou YP, Cai XJ: Polypropylene mesh-reinforced pancreaticojejunostomy for periampullar neoplasm. / World J Gastroenterol 2007, 13:6072-075. CrossRef
  7. Li W, Wang XF, Xu B, Zhu YP, Mou YP: Polypropylene mesh wrap around reinforced pancreatojejunostomy for soft pancreas. / Zhonghua Yi Xue Za Zhi 2009, 89:1391-394.
  8. Peng SY, Wang JW, Lau YW, Cai XJ, Mou YP, Liu YB, Li JT: Conventional versus binding pancreaticojejunostomy after pancreaticoduodenectomy: a prospective randomized trial. / Ann Surg 2007, 245:692-98. CrossRef
  9. Peng SY, Mou YP, Liu YB, Su Y, Peng CH, Cai XJ, Wu YL, Zhou LH: Binding pancreaticojejunostomy: 150 consecutive cases without leakage. / J Gastrointest Surg 2003, 7:898-00. CrossRef
  10. Wang X, Zhou W, Xin Y, Huang D, Mou Y, Cai X: A new technique of polypropylene mesh-reinforced pancreaticojejunostomy. / Am J Surg 2007, 194:413-15. CrossRef
  11. Satoi S, Toyokawa H, Yanagimoto H, Yamamoto T, Hirooka S, Yui R, Yamaki S, Matsui Y, Mergental H, Kwon AH: Reinforcement of pancreticojejunostomy using polyglycolic acid mesh and fibrin glue sealant. / Pancreas 2011, 40:16-0. CrossRef
  12. Amid PK: Classification of biomaterials and their related complications in abdominal wall hernia surgery. / Hernia 1997, 1:15-1. CrossRef
  13. Nordback I, Parviainen M, Piironen A, R?ty S, Sand J: Obstructed pancreaticojejunostomy partly explains exocrine insufficiency after pancreatic head resection. / Scand J Gastroenterol 2007, 42:263-70. CrossRef
  
• 作者单位：Wang Xianfa (1)
  Xin Ying (1)
  Pan Junhai (1)
  Zhang Nengyun (1)
  Zhou Wei (1)
  
  1. Department of General Surgery, Sir Run Run Shaw Hospital, Medical School, Zhejiang University, Institute of Micro-invasive Surgery of Zhejiang University, No.3, Qin Chun Road, Hangzhou, China
  

文摘

Background Pancreatic leak was the major concern after pancreatoduodenectomy. Methods A total of 61 patients who underwent mesh-reinforced pancreatojejunostomy or pancreatogastrostomy from August 2005 to November 2011 were retrospectively analyzed. Results The mean anastomosis time of mesh-reinforced pancreatojejunostomy was 25 minutes ranging from 22 to 35 minutes. In mesh-reinforced pancreatogastrostomy, the mean anastomosis time ranged from 20 to38 minutes with an average of 30 minutes. Blood loss was 200 to 4,000?ml with an average of 710?ml in all patients. There was one case of pancreatic leak of Class A, three cases of pancreatic leak of Class B, one case of pancreatic leak of Class C, one case of choledochojejunostomy leakage, one case of gastrojejunostomy leakage, and three cases of abdominal bleeding. Conclusion As a new technique, mesh-reinforced pancreatojejunostomy and pancreatogastrostomy might be a safe and feasible procedure to prevent postoperative pancreatic leak. Trial registration This research is waivered from trial registration because it was a retrospective analysis of medical records.