Abstract:
Objective To explore the main operation points and clinical effects of the combined application of “Hong’s one stitch" method and “Chen’s suture technique” in complete laparoscopic pancreaticoduodenectomy (LPD).
Methods The clinical data of 65 patients who underwent total LPD with the combined application of “Hong’s one stitch" method and “Chen’s suture technique” in The First Affiliated Hospital of Bengbu Medical College from April 2018 to November 2020 were retrospectively analyzed.
Results All of the patients underwent complete specimen resection and gastrointestinal reconstruction under laparoscopy. Intraoperative observation indices were as follows: average operation time, (291.08±58.77) min; average specimen resection time, (159.54±31.50) min; average pancreaticojejunostomy time, (43.38±6.32) min; average intraoperative blood loss, (151.54±102.69) mL; and proportion of patients undergoing blood transfusion, 6.15% (4/65). Postoperative situation: complications: there were 12 cases of grade A pancreatic fistula, 5 cases of grade B pancreatic fistula, 4 cases of biliary, 4 cases of emptying disorder, 2 cases of lung infection, 2 cases of abdominal effusion, and 1 case of gastrointestinal bleeding. The average time the patients took to progress from being bedridden after the operation was (2.26±0.59) d, the mean postoperative exhaust time was (3.91+0.76) d, the average postoperative eating time was (4.57±0.75) d, the average postoperative hospital stay was (14.28±5.42) d. There was no case of mortality in the perioperative period. One patient was re-admitted after discharge due to gastrointestinal bleeding. DSA angiography revealed gastroduodenal artery aneurysm bleeding, which was cured after embolization.
Conclusions In summary, the combination of “Hong’s one stitch" method and “Chen’s suture technique” in complete LPD decreases pancreaticojejunostomy time, increases the safety of the operation method, decreases the rate of postoperative pancreatic fistulas, allows for safer and more accurate anastomosis, and is worthy of clinical application.