Abstract：
BACKGROUND: No single technique of remnant pancreas reconstruction after pancreaticoduodenectomy (PD) has been demonstrated to be superior to the others in the prevention of post-operative pancreatic fistula (POPF), and the accumulation of surgical experience is closely related to the quality of this anastomosis. The aim of the current study was to evaluate the feasibility and patient outcomes of a simplified technique involving a single-layer continuous pancreaticojejunostomy (PJA) with Falciform ligament reinforcement that can be used with all types of pancreases.
METHODS: A single-centre and single-surgeon study was performed. One hundred consecutive patients undergoing pancreatic resection with subsequent PJA using a novel technique performed by a single surgeon were included in the study. Patient demographics, pre-operative treatments, risk factors for POPF, and post-operative morbidity and mortality and long-term patient outcome were prospectively recorded and reported.
RESULTS: From March 2018 to March 2022, 59 male and 41 female patients were included. 91 patients underwent PD for malignancy with 32 receiving neoadjuvant treatment. 59 patients were classified as intermediate/high risk for POPF according to validated fistula prediction models. There were 12 POPF Type B and 2 POPF Type C. The overall morbidity rate was 16% with no 90-day mortality. 3 patients underwent reoperation. The median length of hospitalisation was 12.6 days and 82% of eligible patients commenced and completed adjuvant chemotherapy.
CONCLUSIONS: Single-layer continuous dunking PJA with Falciform ligament reinforcement is a simplified and feasible method for PJA with a low associated complication rate.
METHODS: A single-centre and single-surgeon study was performed. One hundred consecutive patients undergoing pancreatic resection with subsequent PJA using a novel technique performed by a single surgeon were included in the study. Patient demographics, pre-operative treatments, risk factors for POPF, and post-operative morbidity and mortality and long-term patient outcome were prospectively recorded and reported.
RESULTS: From March 2018 to March 2022, 59 male and 41 female patients were included. 91 patients underwent PD for malignancy with 32 receiving neoadjuvant treatment. 59 patients were classified as intermediate/high risk for POPF according to validated fistula prediction models. There were 12 POPF Type B and 2 POPF Type C. The overall morbidity rate was 16% with no 90-day mortality. 3 patients underwent reoperation. The median length of hospitalisation was 12.6 days and 82% of eligible patients commenced and completed adjuvant chemotherapy.
CONCLUSIONS: Single-layer continuous dunking PJA with Falciform ligament reinforcement is a simplified and feasible method for PJA with a low associated complication rate.
摘要：
背景：胰十二指肠切除术（PD）后残余胰腺重建技术在预防术后胰瘘（POPF）方面没有证明优于其他技术，手术经验的积累与这种吻合的质量密切相关。本研究的目的是评估一种简化技术的可行性和患者预后，该技术涉及单层连续胰肠吻合术（PJA），并带有Falciform韧带加固，可用于所有类型的胰腺。
方法：进行单中心和单外科医生研究。该研究包括一百名连续的患者，这些患者使用由一名外科医生执行的新技术进行胰腺切除术和随后的PJA。患者人口统计学，术前治疗,POPF的危险因素，前瞻性记录和报告术后发病率和死亡率以及长期患者结局.
结果：从2018年3月至2022年3月，包括59名男性和41名女性患者。91例患者因恶性肿瘤接受PD，其中32例接受新辅助治疗。根据验证的瘘管预测模型，59例患者被分类为POPF的中/高风险。有12个POPFB型和2个POPFC型。总发病率为16％，无90天死亡率。3例患者再次手术。中位住院时间为12.6天，82%的合格患者开始并完成辅助化疗。
结论：Falciform韧带加固单层连续灌洗PJA是一种简化可行的PJA方法，相关并发症发生率低。
方法：进行单中心和单外科医生研究。该研究包括一百名连续的患者，这些患者使用由一名外科医生执行的新技术进行胰腺切除术和随后的PJA。患者人口统计学，术前治疗,POPF的危险因素，前瞻性记录和报告术后发病率和死亡率以及长期患者结局.
结果：从2018年3月至2022年3月，包括59名男性和41名女性患者。91例患者因恶性肿瘤接受PD，其中32例接受新辅助治疗。根据验证的瘘管预测模型，59例患者被分类为POPF的中/高风险。有12个POPFB型和2个POPFC型。总发病率为16％，无90天死亡率。3例患者再次手术。中位住院时间为12.6天，82%的合格患者开始并完成辅助化疗。
结论：Falciform韧带加固单层连续灌洗PJA是一种简化可行的PJA方法，相关并发症发生率低。
