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The level of pancreatic neck transection during laparoscopic pancreaticoduodenectomy (LPD) is not conclusive. Theoretically, the level of pancreatic transection can significantly affect the occurrence of postoperative pancreatic fistula (POPF) by influencing both the blood supply to the anastomosis and the location of the main pancreatic duct in the pancreatic transverse section. The investigators conduct a retropective propensity score-matched comparison to compare the impact of extended pancreatic transection and conventional pancreatic transection on POPF and the performance of the pancreaticojejunostomy during LPD.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| extended pancreatic transection cohort | cases in which the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan. |
| |
| conventional pancreatic transection cohort | cases in which the pancreatic transection was performed at the pancreatic neck above the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| extended pancreatic transection during laparoscopic pancreaticoduodenectomy | Procedure | the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy |
| Measure | Description | Time Frame |
|---|---|---|
| the incidence of clinically relevant pancreatic fistula | the incidence of the clinically relevant pancreatic fistula according the International Study Group of Pancreatic Surgery's definition and grading | 3 months postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| surgical performance of pancreaticojejunostomy | the duration of pancreaticojejunostomy | intraoperatively |
| postoperative morbidity | postoperative morbidity (Clavien-Dindo score ≥3) within 3 months postoperatively |
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Inclusion Criteria:
Exclusion Criteria:
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patients who had underwent laparoscopic pancreaticoduodenectomy
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yunqiang Cai | Contact | +862862539242 | yunqiangcaiwch@163.com | |
| Bing Peng | Contact | pengbing84@hotmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Bing Peng | West China Hospital | Study Chair |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32841726 | Background | Bardol T, Delicque J, Hermida M, Herrero A, Guiu B, Fabre JM, Souche R. Neck transection level and postoperative pancreatic fistula after pancreaticoduodenectomy: A retrospective cohort study of 195 patients. Int J Surg. 2020 Oct;82:43-50. doi: 10.1016/j.ijsu.2020.08.001. Epub 2020 Aug 22. | |
| 28990000 | Background |
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| 3 months postoperatively |
| postoperative mortality | mortality within 3 months postoperatively | 3 months postoperatively |
| Jwa EK, Hwang S. Extended pancreatic transection for secure pancreatic reconstruction during pancreaticoduodenectomy. Ann Hepatobiliary Pancreat Surg. 2017 Aug;21(3):138-145. doi: 10.14701/ahbps.2017.21.3.138. Epub 2017 Aug 31. |
| 12081065 | Background | Strasberg SM, Drebin JA, Mokadam NA, Green DW, Jones KL, Ehlers JP, Linehan D. Prospective trial of a blood supply-based technique of pancreaticojejunostomy: effect on anastomotic failure in the Whipple procedure. J Am Coll Surg. 2002 Jun;194(6):746-58; discussion 759-60. doi: 10.1016/s1072-7515(02)01202-4. |