Abstract:

Objective

To analyze the possible difference in the incidence of pancreatic leakage relative to two methods of pancreaticoduodenectomy(PD).

Methods

A retrospective review of 154 consecutive patients who underwent PD between Feb 2002 and May 2007 was carried out. 105 cases were used a single-deck invaginated pancreaticojejunostomy, 49 cases were double-deck invaginated.Risk factors associated with leakage were determined for all 154 cases and then outcomes for each group were compared.

Results

Leakage was observed in13 of 154 cases (8.4%).Uni-and multivariate analysis showed three independent risk factors for leakage:male gender;not using a single-deck invaginated pancreaticojejunostomy; soft pancreatic gland.The leakage rate in the single-deck group was 4.8%（5 of 105）and in the double-deck group was 16.4%(8 of 49,P=0.016).The postoperation complication was 18.1%in single-deck group while 32.7%in the double-deck group.The mean length of stay after PD was longer in the double-deck group (22.75±9.73 days)as compared to the single-deck group (18.45±7.11 days).The leakage rate was 6%in the single-deck group vs 27.4%in the double-deck group(P=0.014).

Conclusion

The single-deck invaginated pancreaticojejunostomy decreases leakage significantly,particularly when a patient has soft pancreatic gland.

Key words: Pancreaticoduodenectomy, Pancreatic lekage, Anastomotic methods