Feng Yang1, Chen Jin1, Yang Di1, Hang He1, Sijie Hao1, Lie Yao1, Ji Li1, Deliang Fu2. 1. Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China. 2. Department of Pancreatic Surgery, Pancreatic Disease Institute, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China. Electronic address: fudeliang@huashan.org.cn.
Abstract
OBJECTIVE: Postoperative pancreatic fistula (POPF) remains a common problem and leading cause of morbidity and mortality after central pancreatectomy (CP). The aim of this study was to present a technique of external drainage of monolayer pancreaticojejunostomy for prevention of POPF. METHODS: Patients received elective CP with external drainage of monolayer pancreaticojejunostomy between January 2010 and December 2016 were retrospectively analyzed. The occurrence and severity of POPF, overall complications, reoperation rate, in-hospital mortality, and length of postoperative hospital stay were measured. The 2016 updated definition and classification system of the International Study Group of Pancreatic Surgery (ISGPS) was used for POPF. In addition, a matched-pairs comparison with internal drainage of pancreaticojejunostomy was made. RESULTS: 33 consecutive patients underwent CP with external drainage of monolayer pancreaticojejunostomy during this period. 4 (12.1%) cases developed grade B POPF, among which one patient was classified as having Clavien-Dindo classification IIIa complication. None of the patients developed grade C POPF, delayed gastric emptying, or postpancreatectomy hemorrhage. There was no reoperation or in-hospital mortality occurred. Matched-pairs comparison revealed that patients with external drainage of pancreaticojejunostomy had significantly lower incidence of POPF. CONCLUSION: External drainage of monolayer pancreaticojejunostomy seems effective in prevention of POPF after CP.
OBJECTIVE:Postoperative pancreatic fistula (POPF) remains a common problem and leading cause of morbidity and mortality after central pancreatectomy (CP). The aim of this study was to present a technique of external drainage of monolayer pancreaticojejunostomy for prevention of POPF. METHODS:Patients received elective CP with external drainage of monolayer pancreaticojejunostomy between January 2010 and December 2016 were retrospectively analyzed. The occurrence and severity of POPF, overall complications, reoperation rate, in-hospital mortality, and length of postoperative hospital stay were measured. The 2016 updated definition and classification system of the International Study Group of Pancreatic Surgery (ISGPS) was used for POPF. In addition, a matched-pairs comparison with internal drainage of pancreaticojejunostomy was made. RESULTS: 33 consecutive patients underwent CP with external drainage of monolayer pancreaticojejunostomy during this period. 4 (12.1%) cases developed grade B POPF, among which one patient was classified as having Clavien-Dindo classification IIIa complication. None of the patients developed grade C POPF, delayed gastric emptying, or postpancreatectomy hemorrhage. There was no reoperation or in-hospital mortality occurred. Matched-pairs comparison revealed that patients with external drainage of pancreaticojejunostomy had significantly lower incidence of POPF. CONCLUSION: External drainage of monolayer pancreaticojejunostomy seems effective in prevention of POPF after CP.