Invaginated Duct to Mucosa Pancreaticojejunostomy Reduced Pstoperative Pancreatic Leakage: A Matched Case-Controlled Study

Background: Postoperative pancreatic leakage was also the obstacle of pancreaticoduodenectomy (PD) which always followed the failure of pancreaticojejunostomy. Dozens of pancreaticojejunostomy had been reported. None showed superiority over others. To assess the potential advantages of invaginated duct to mucosa pancreaticojejunostomy (invaginated D-M PJ), we introduced this study. Methods: Retrospectively analyzed the related data from the patients who had their pancreaticodedunostomy due to malignant tumor in The First Affiliated Hospital to Henan University of Science and Technology during January 2017 to August 2019. According to the different procedure of pancreaticojejunostomy, the patients divided into custom D-M group and invaginated D-M group. Sex, age, pancreatic duct size and pancreatic texture were matched. Pancreatic leakage and other complications were compared. SPSS 16.0 was employed for analysis. Results: 48 pairs of patients were involved. Both groups had almost the same baseline characterisitics, such as Sex (P=1.000), Age (P=0.897), ASA (P=0.575), BMI (P=0.873), pancreatic duct size (P=0.932), pancreatic texture (P=1.000) and tumor origin (P=0.686). No statistical difference was observed relation to operation outcomes, such as operation time (P=0.632), pancreaticojejunostomy time (P=0.748), blood loss (P=0.617) and number of required transfusion (P=0.523). Pancreatic leakage was significantly declined for invaginated D-M group (P=0.005). The difference of other complications, such as, bleeding (P=0.617), biliary leakage (P=0.646), pneumonia (P=0.594) and thrombosis (P=0.714), didn’t reach statistical significance. Postoperative hospitalization was almost the same for both groups (P=0.764). Conclusions: Invaginated D-M PJ could reduce pancreatic leakage followed PD. Invaginated D-M PJ should be a choice for the patients who had PD.