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Erschienen in: Surgical Endoscopy 5/2019

10.09.2018

A novel technique of pancreaticojejunostomy for laparoscopic pancreaticoduodenectomy

verfasst von: Yunqiang Cai, Hua Luo, Yongbin Li, Pan Gao, Bing Peng

Erschienen in: Surgical Endoscopy | Ausgabe 5/2019

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Abstract

Background

Pancreaticojejunostomy (PJ) reconstruction is the Achilles’ heel of laparoscopic pancreaticoduodenectomy (LPD). However, only a few studies have focused on the performance of this difficult procedure laparoscopically.

Methods

We present a safe and feasible technique of duct-to-mucosa pancreaticojejunostomy for LPD, named Bing’s anastomosis. Our study included 238 cases of LPDs that underwent Bing’s anastomosis. Data on the demographic characteristics, operative outcomes (total operative time, PJ duration, and estimated blood loss), and postoperative results (length of hospital stay, recovery of bowel function, and rates of postoperative morbidity and mortality) of the cases were prospectively collected and retrospectively analyzed.

Results

Only one patient (0.4%) in our series required conversion to open surgery as a result of uncontrolled bleeding from the superior mesenteric artery. The average operative time was 358 min (220 min to 495 min). The mean duration for PJ was 23 min (19 min to 33 min). The mean estimated blood loss was 112 ml (50 ml to 800 ml). The overall incidence of pancreatic fistula was 21.4% and included 42 cases (17.6%) of biochemical leak, eight cases (3.4%) of Grade B, and one case (0.4%) of Grade C pancreatic fistulas. The 90-day mortality was 0.4%.

Conclusions

Bing’s anastomosis is a safe, reliable, and rapid PJ technique for LPD that is associated with favorable outcomes and a low risk of pancreatic fistula. However, its safety and feasibility should be verified by performing prospective randomized controlled trials at different institutions.
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Metadaten
Titel
A novel technique of pancreaticojejunostomy for laparoscopic pancreaticoduodenectomy
verfasst von
Yunqiang Cai
Hua Luo
Yongbin Li
Pan Gao
Bing Peng
Publikationsdatum
10.09.2018
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 5/2019
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6446-z

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