A reinforced suture method for stapled gastrointestinal anastomosis to reduce gastrointestinal hemorrhage during Whipple operation in laparoscopy

La Zhang; Ning Jiang; Liujun Jiang; Rui Liao; Lei Xiang; Baoyong Zhou; Dewei Li

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저자정보: La Zhang (The First Affiliated Hospital of Chongqing Medical University) Ning Jiang (Chongqing Medical University) Liujun Jiang (The First Affiliated Hospital of Chongqing Medical University) Rui Liao (The First Affiliated Hospital of Chongqing Medical University) Lei Xiang (The First Affiliated Hospital of Chongqing Medical University) Baoyong Zhou (The First Affiliated Hospital of Chongqing Medical University) Dewei Li (The First Affiliated Hospital of Chongqing Medical University)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.102 No.2

발행연도: 2022.2

수록면: 110 - 116 (7page)

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Purpose: Laparoscopy is being increasingly accepted for pancreaticoduodenectomy. Stapled anastomosis (SA) is used extensively to facilitate laparoscopic pancreaticoduodenectomy (LPD); however, the incidence of anastomotic bleeding after stapled gastrointestinal anastomosis is still high.
Methods: One hundred and thirty-nine patients who underwent LPD using Whipple method were enrolled in our study. We performed the SA with our reinforced method (n = 68, R method) and without the method (n = 71, NR method). We compared the clinical characteristics and anastomosis methods of patients with or without gastrointestinal-anastomotic hemorrhage (GAH), and operative parameters were also compared between the anastomotic methods.
Results: Of the 139 patients undergoing LPD, 15 of them developed GAH. The clinical characteristics of patients with or without GAH were not significantly different except in the anastomotic method (P < 0.001). In the univariate logistic regression analyses, only the anastomotic method was associated with GAH. Furthermore, patients with the NR method had significantly higher incidences of GAH (P < 0.001) and Clavien-Dindo grade ≥ III complications (P < 0.001).
Conclusion: Our retrospective analysis showed that the SA performed with reinforced method might be a reform of SA without the reinforcement, as indicated by the lower incidence of GAH. However, further research is necessary to evaluate the utility of this reinforced method.

#Pancreaticoduodenectomy #Postoperative hemorrhage #Surgical anastomosis

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