Treatment experience of postoperative complications after laparoscopic pancreati- coduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Sirui ^1,2 , CAI Yunqiang ¹ ,  PENG Bing ¹

1. Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;
2. Department of Hepatobiliary Surgery, Mianyang Central Hospital of Sichuan Province, Mianyang, Sichuan 621000, P.R.China;

Corresponding author：

PENG Bing, Email: pengbing84@hotmail.com

Keywords：

laparoscopic pancreaticoduodenectomy; postoperative complication; treatment experience

DOI：

10.7507/1007-9424.201609052

Video：

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Objective To investigate the occurrence and treatment of postoperative complications after laparoscopic laparoscopic pylorus-preserving pancreaticoduodenectomy (LPPPD) or pancreaticoduodenectomy (LPD). Method The clinical data of 130 patients undergoing LPD from October 2010 to December 2015 in West China Hospital of Sichuan University were analyzed retrospectively. Results Of 130 patients, postoperative complications occurred in 55 cases, including 24 cases of pancreatic fistula, 14 cases of gastric emptying disorder, 3 cases of anastomotic bleeding, 6 cases of peritoneal infection, 1 case of bile leakage, 1 case of venous thrombosis, 1 case of chylous leakage, 5 cases of peritoneal effusion, without the occurrence of stress ulcer and incision complications. There were significant difference in the incidence of pancreatic fistula (P=0.025), gastric emptying disorder (P=0.034), anastomotic bleeding (P=0.020), and peritoneal infection (P=0.016) among prophase group, metaphase group, and the later stage group. Conclusions The most common complication after LPD is pancreatic fistula. With the improvement of surgical techniques and procedures, incidences of some postoperative complications decreases gradually.

Citation： CHEN Sirui, CAI Yunqiang, PENG Bing. Treatment experience of postoperative complications after laparoscopic pancreati- coduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(7): 819-824. doi: 10.7507/1007-9424.201609052 Copy

1.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
2.	Palanivelu C, Jani K, Senthilnathan P, et al. Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg, 2007, 205(2): 222-230.
3.	Kendrick ML. Laparoscopic and robotic resection for pancreatic cancer. Cancer J, 2012, 18(6): 571-576.
4.	王艺超, 彭兵, 吴仲. 腹腔镜胰十二指肠切除术治疗十二指肠乳头管状绒毛腺瘤一例. 华西医学, 2011, 26(7): 974.
5.	Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery, 2005, 138(1): 8-13.
6.	Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2007, 142(5): 761-768.
7.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
8.	吴传有, 刘长安, 李生伟. 胰十二指肠切除术后胰瘘的预防. 现代临床医学, 2014, 40(2): 86-88.
9.	Adam U, Makowiec F, Riediger H, et al. Risk factors for complications after pancreatic head resection. Am J Surg, 2004, 187(2): 201-208.
10.	张华, 王明俊, 王昕, 等. 腹腔镜胰十二指肠切除术 45 例体会. 中国普外基础与临床杂志, 2014, 21(8): 940-945.
11.	Kawaguchi M, Ishikawa N, Shimada M, et al. Laparoscopic pancreaticoduodenectomy after endovascular repair for abdominal aortic aneurysm. Int J Surg Case Rep, 2013, 4(12): 1117-1119.
12.	Mesleh MG, Stauffer JA, Asbun HJ. Minimally invasive surgical techniques for pancreatic cancer: ready for prime time? J Hepatobiliary Pancreat Sci, 2013, 20(6): 578-582.
13.	Cho A, Yamamoto H, Kainuma O, et al. Performing simple and safe dunking pancreaticojejunostomy using mattress sutures in pure laparoscopic pancreaticoduodenectomy. Surg Endosc, 2014, 28(1): 315-318.
14.	Cho A, Yamamoto H, Kainuma O. Tips of laparoscopic pancreaticoduodenectomy: superior mesenteric artery first approach (with video). J Hepatobiliary Pancreat Sci, 2014, 21(3): E19-E21.
15.	林浩铭, 李国林, 常瑞明, 等. 动脉入路腹腔镜胰十二指肠切除 19 例报道. 中国普外基础与临床杂志, 2014, 21(10): 1237-1240.
16.	Park YC, Kim SW, Jang JY, et al. Factors influencing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy. J Am Coll Surg, 2003, 196(6): 859-865.
17.	Traverso LW, Hashimoto Y. Delayed gastric emptying: the state of the highest level of evidence. J Hepatobiliary Pancreat Surg, 2008, 15(3): 262-269.
18.	李永彬, 王昕, 王明俊, 等. 腹腔镜与开腹手术影响胰十二指肠切除术后胃排空延迟的对比研究. 中华外科杂志, 2013, 51(4): 304-307.
19.	刘强. 胰十二指肠切除术并发症临床分析. 中外医学研究, 2014, 12(13): 122-123.
20.	纪伟平, 邵卓, 沈力, 等. 胰十二指肠切除术后乳糜漏的成因分析和治疗手段. 肝胆胰外科杂志, 2013, 26(1): 12-15.
21.	Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases. Surg Endosc, 2006, 20(7): 1045-1050.
22.	Kendrick ML, Cusati D. Total laparoscopic pancreati coduodenectomy: feasibility and outcome in an early experience. Arch Surg, 2010, 145(1): 19-23.
23.	Giulianotti PC, Sbrana F, Bianco FM, et al. Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc, 2010, 24(7): 1646-1657.
24.	Zureikat AH, Breaux JA, Steel JL, et al. Can laparoscopic pancreaticoduodenectomy be safely implemented? Gastrointest Surg, 2011, 15(7): 1151-1157.
25.	鲁超, 金巍巍, 牟一平, 等. 腹腔镜胰十二指肠切除术的学习曲线. 外科理论与实践, 2015, 20(6): 485-489.
26.	Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.

1. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
2. Palanivelu C, Jani K, Senthilnathan P, et al. Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg, 2007, 205(2): 222-230.
3. Kendrick ML. Laparoscopic and robotic resection for pancreatic cancer. Cancer J, 2012, 18(6): 571-576.
4. 王艺超, 彭兵, 吴仲. 腹腔镜胰十二指肠切除术治疗十二指肠乳头管状绒毛腺瘤一例. 华西医学, 2011, 26(7): 974.
5. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery, 2005, 138(1): 8-13.
6. Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2007, 142(5): 761-768.
7. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6 336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
8. 吴传有, 刘长安, 李生伟. 胰十二指肠切除术后胰瘘的预防. 现代临床医学, 2014, 40(2): 86-88.
9. Adam U, Makowiec F, Riediger H, et al. Risk factors for complications after pancreatic head resection. Am J Surg, 2004, 187(2): 201-208.
10. 张华, 王明俊, 王昕, 等. 腹腔镜胰十二指肠切除术 45 例体会. 中国普外基础与临床杂志, 2014, 21(8): 940-945.
11. Kawaguchi M, Ishikawa N, Shimada M, et al. Laparoscopic pancreaticoduodenectomy after endovascular repair for abdominal aortic aneurysm. Int J Surg Case Rep, 2013, 4(12): 1117-1119.
12. Mesleh MG, Stauffer JA, Asbun HJ. Minimally invasive surgical techniques for pancreatic cancer: ready for prime time? J Hepatobiliary Pancreat Sci, 2013, 20(6): 578-582.
13. Cho A, Yamamoto H, Kainuma O, et al. Performing simple and safe dunking pancreaticojejunostomy using mattress sutures in pure laparoscopic pancreaticoduodenectomy. Surg Endosc, 2014, 28(1): 315-318.
14. Cho A, Yamamoto H, Kainuma O. Tips of laparoscopic pancreaticoduodenectomy: superior mesenteric artery first approach (with video). J Hepatobiliary Pancreat Sci, 2014, 21(3): E19-E21.
15. 林浩铭, 李国林, 常瑞明, 等. 动脉入路腹腔镜胰十二指肠切除 19 例报道. 中国普外基础与临床杂志, 2014, 21(10): 1237-1240.
16. Park YC, Kim SW, Jang JY, et al. Factors influencing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy. J Am Coll Surg, 2003, 196(6): 859-865.
17. Traverso LW, Hashimoto Y. Delayed gastric emptying: the state of the highest level of evidence. J Hepatobiliary Pancreat Surg, 2008, 15(3): 262-269.
18. 李永彬, 王昕, 王明俊, 等. 腹腔镜与开腹手术影响胰十二指肠切除术后胃排空延迟的对比研究. 中华外科杂志, 2013, 51(4): 304-307.
19. 刘强. 胰十二指肠切除术并发症临床分析. 中外医学研究, 2014, 12(13): 122-123.
20. 纪伟平, 邵卓, 沈力, 等. 胰十二指肠切除术后乳糜漏的成因分析和治疗手段. 肝胆胰外科杂志, 2013, 26(1): 12-15.
21. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases. Surg Endosc, 2006, 20(7): 1045-1050.
22. Kendrick ML, Cusati D. Total laparoscopic pancreati coduodenectomy: feasibility and outcome in an early experience. Arch Surg, 2010, 145(1): 19-23.
23. Giulianotti PC, Sbrana F, Bianco FM, et al. Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc, 2010, 24(7): 1646-1657.
24. Zureikat AH, Breaux JA, Steel JL, et al. Can laparoscopic pancreaticoduodenectomy be safely implemented? Gastrointest Surg, 2011, 15(7): 1151-1157.
25. 鲁超, 金巍巍, 牟一平, 等. 腹腔镜胰十二指肠切除术的学习曲线. 外科理论与实践, 2015, 20(6): 485-489.
26. Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.

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Treatment experience of postoperative complications after laparoscopic pancreati- coduodenectomy

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