Abstract:
Objective:To investigate and summarize the procedures of direct-covering pancreaticojejunos -tomy with remaining jejunal mucosa in pancreaticoduodenectomy and to analyze the incidence of pancreatic fistula and other postoperative complications. Methods:A total of 21patients were treated with pancreaticodu-odenectomy between May 2005 and June 2009. During the surgery, we dissected 3cm long remnant of the pancreas out of ambient tissues. Near the 2.0-3.0cm of the pancreatic remnant, we fixed partial posterior wall with the full-thickness jejunum without mucosa destroyed by interrupted suture, and then pushed the remnant into the jejunum and fixed the anterior wall. Finally, at the 1.0cm of the panceratic remnant, we binded the jeju -num to surround the pancreas through 7-silk sutures. Results: One case was treated with secondary surgery due to bleeding of the pancreatic remnant. The other patients recovered smoothly without pancreatic fistula or other complications. Conclusion:Postoperative pancreatic fistula is related to the texture of pancreas, method of pancreaticojejunostomy, surgical skills and perioperative treatment. Compared with other types of pancreati-cojejunostomy, direct covering pancreaticojejunostomy with remaining jejunal mucosa is simpler.