To study the influence of Suspension Pancreatic-Duct-Jejunum End-to-Side Continuous Suture Anastomosis (SPDJCS) on the incidence of pancreatic fistula after pancreaticoduodenectomy

and to analyze its applicability

safety

and efficacies. Methods A prospective controlled trial was conducted with 165 cases receiving pancreaticoduodenectomy in the Department of Hepatopancreatobiliary Surgery from January 2010 to May 2012. The patients were divided into Group A (end-to-end/end-to-side invaginated anastomosis

n=52)

Group B (end-to-side mucosal anastomosis

n=48)

and Group C (SPDJCS

n=65). The preoperative data

intraoperative data

and operative outcomes (incidence of pancreatic fistula

operation time

intraoperative blood loss

peritoneal drainage

peritoneal hemorrhage

peritoneal abscess

delayed gastric emptying

pulmonary infection

postoperative infection

blood transfusion

and perioperative mortality) were compared among the 3 groups. Results The total incidence of pancreatic fistula was 13.9% (23/165) in all the 165 patients. The incidence in Group A and Group B was 23.1% (12/52) and 18.8% (9/48)

both higher than that in Group C [3.1% (2/65)

both P<0.05]. Group C showed significantly better outcomes than group A and B in terms of the operation time (5.5±1.2 hours vs. 6.1±1.1 hours

5.5±1.2 hours vs. 6.3±1.5 hours)

volume of blood loss (412.0±205.0 mL vs. 525.0±217.0 mL

412.0±205.0 mL vs. 514.0±217.0 mL)

and postoperative drainage amount of plasma tubes (175.0±65.0 mL vs. 275.0±80.0 mL

175.0±65.0 mL vs. 255.0±75.0 mL) (all P<0.05)

while Group A and Group B displayed no difference in these aspects (P>0.05). As complications other than pancreatic fistula were concerned

the three groups were not different from each other (P>0.05). Conclusions SPDJCS may have the effect of reducing the incidence of pancreatic fistula after pancreaticoduodenectomy. It could be safe

practical and convenient technique of anastomosis for pancreaticojejunostomy.