Application value of pancreatic stump suspension technique via abdominal wall in pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy
Objective To investigate the application value of pancreatic stump suspension technique through abdominal wall in pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy(LPD).Methods The clinical data of 87 patients who underwent LPD by the same surgical team in Huzhou Central Hospital from January 2014 to June 2024 were retrospectively analyzed.There were 45 patients who underwent pancreatic stump suspension through the abdominal wall during pancreaticointestinal anastomosis(suspension group),and 42 patients who did not undergo suspension(conventional group).The preoperative general data(age,body mass index,laboratory examination,underlying diseases),intraoperative indicators(pancreatic texture,tumor diameter,pancreaticojejunostomy time,blood loss volume,and operation time),and postoperative indicators(postoperative pathology,lymph node metastasis,postoperative complications,postoperative hospital stay,and hospitalization expenses)were compared between the two groups.Univariate and multivariate logistic regression was used to analyze the independent risk factors of postoperative pancreatic fistula(POPF).Results There were no significant differences in preoperative general data between the two groups(all P>0.05),neither were in pancreatic texture,tumor diameter,pancreatic duct diameter and intraoperative blood loss volume between the two groups(all P>0.05).However,the pancreaticojejunostomy time and operation time in the suspension group were both significantly shorter than those in the conventional group,with statistically significant differences(both P<0.05).No significant differences were observed between the two groups in postoperative pathology,lymph node metastasis,postoperative complications and hospitalization costs(P>0.05).However,the postoperative hospital stay in the suspension group was shorter than that of the conventional group,and the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that pancreatic duct diameter was high risk factors for POPF after LPD,and soft texture of the pancreas was a protective facton(both P<0.05).Conclusion The technique of pancreatic stump suspension through abdominal wall is easy to operate and has high quality of anastomosis.It can shorten the time of pancreaticojejunostomy and the operation time,which is safe and effective,and worthy of clinical promotion.