Decreased pancreatic leakage rate in the application of a measurable variable-diameter pancreatic duct catheter in laparoscopic pancreaticoduodenectomy

Qiusheng Li; Xinbo Zhou; Jiayue Duan; Zhongqiang Xing; Ziqiang Wu; Weihong Zhao; Jianhua Liu

doi:10.21037/gs-22-478

Decreased pancreatic leakage rate in the application of a measurable variable-diameter pancreatic duct catheter in laparoscopic pancreaticoduodenectomy

Gland Surg. 2022 Sep;11(9):1546-1554. doi: 10.21037/gs-22-478.

Authors

Qiusheng Li¹, Xinbo Zhou¹, Jiayue Duan¹, Zhongqiang Xing¹, Ziqiang Wu¹, Weihong Zhao¹, Jianhua Liu¹

Affiliation

¹ Hepatobiliary and Pancreatic Surgery Department, The Second Hospital of Hebei Medical University, Shijiazhuang, China.

Abstract

Background: Pancreatic leakage remains one of the most serious complications after laparoscopic pancreaticoduodenectomy (LPD). At present, most medical centers use local materials for the common pancreatic duct catheters required for pancreaticoenterostomy. However, there is a lack of a measurable and variable-diameter pancreatic duct catheter. Recently, a measurable variable-diameter pancreatic duct catheter was developed to remedy the limitation of the common pancreatic duct catheters. This study sought to evaluate its preventive effect on pancreatic leakage in LPD.

Methods: A total of 202 patients who underwent LPD using the Hong's single-stitch method from January 2021 to April 2022 were included in the study. Patients were divided into the 2 groups: the variable-diameter group (n=111) and the normal group (n=91) according to the application of different pancreatic duct catheters. Patient characteristics and perioperative data, including operation time, pancreatic fistula rate, postoperative bleeding rate and postoperative length of stay in the two groups were collected and analyzed. The Chi-square test was used to compare the differences between the groups in relation to the categorical variables.

Results: Among the 202 patients, there were 123 males and 79 females, with an average age of 58.79±7.89 years (range, 15-79 years), and an average body mass index (BMI) of 23.55±4.25 kg/m². There were no statistically significant differences between the variable-diameter group and the normal group in terms of age, sex, BMI, operation time, intraoperative blood loss, preoperative bilirubin, and pancreatic texture (P>0.05). The pancreatic fistula rate (2.70% vs. 9.89%) and postoperative median length of stay (15 vs. 16 days) of the variable-diameter group was significantly lower than that of the normal group.

Conclusions: The measurable variable-diameter pancreatic duct catheter could decrease the pancreatic fistula rate and postoperative median length of stay in the application of laparoscopic duodenectomy.

Keywords: Pancreaticoduodenectomy; laparoscopy; pancreatic leakage.