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.	王藝超, 彭兵, 吳仲. 腹腔鏡胰十二指腸切除術治療十二指腸乳頭管狀絨毛腺瘤一例. 華西醫學, 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.	吳傳有, 劉長安, 李生偉. 胰十二指腸切除術后胰瘺的預防. 現代臨床醫學, 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.	張華, 王明俊, 王昕, 等. 腹腔鏡胰十二指腸切除術 45 例體會. 中國普外基礎與臨床雜志, 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.	林浩銘, 李國林, 常瑞明, 等. 動脈入路腹腔鏡胰十二指腸切除 19 例報道. 中國普外基礎與臨床雜志, 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. 腹腔鏡與開腹手術影響胰十二指腸切除術后胃排空延遲的對比研究. 中華外科雜志, 2013, 51(4): 304-307.
19.	劉強. 胰十二指腸切除術并發癥臨床分析. 中外醫學研究, 2014, 12(13): 122-123.
20.	紀偉平, 邵卓, 沈力, 等. 胰十二指腸切除術后乳糜漏的成因分析和治療手段. 肝膽胰外科雜志, 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.	魯超, 金巍巍, 牟一平, 等. 腹腔鏡胰十二指腸切除術的學習曲線. 外科理論與實踐, 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. 王藝超, 彭兵, 吳仲. 腹腔鏡胰十二指腸切除術治療十二指腸乳頭管狀絨毛腺瘤一例. 華西醫學, 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. 吳傳有, 劉長安, 李生偉. 胰十二指腸切除術后胰瘺的預防. 現代臨床醫學, 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. 張華, 王明俊, 王昕, 等. 腹腔鏡胰十二指腸切除術 45 例體會. 中國普外基礎與臨床雜志, 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. 林浩銘, 李國林, 常瑞明, 等. 動脈入路腹腔鏡胰十二指腸切除 19 例報道. 中國普外基礎與臨床雜志, 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. 腹腔鏡與開腹手術影響胰十二指腸切除術后胃排空延遲的對比研究. 中華外科雜志, 2013, 51(4): 304-307.
19. 劉強. 胰十二指腸切除術并發癥臨床分析. 中外醫學研究, 2014, 12(13): 122-123.
20. 紀偉平, 邵卓, 沈力, 等. 胰十二指腸切除術后乳糜漏的成因分析和治療手段. 肝膽胰外科雜志, 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. 魯超, 金巍巍, 牟一平, 等. 腹腔鏡胰十二指腸切除術的學習曲線. 外科理論與實踐, 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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