APPLICATION OF END-TO-END PANCREATIC DUCT ANASTOMOSIS IN LAPAROSCOPIC MIDDLE PANCREATECTOMY wxzhao@sina.com

 

APPLICATION OF END-TO-END PANCREATIC DUCT ANASTOMOSIS IN LAPAROSCOPIC MIDDLE PANCREATECTOMY

3

China

Oral or Poster

To assess feasibility, safety, and efficacy of laparoscopic middle pancreatectomy (LMP) with pancreatic duct end-to-end anastomosis (PDEA) versus pancreaticojejunostomy (PJ)

Retrospective analysis of 31 patients undergoing LMP (10 PDEA, 21 PJ) between March 2018 and February 2024. Preoperative, intraoperative, and postoperative data, including complications, were compared.

All procedures were completed laparoscopically without conversion or mortality. The PDEA group had significantly shorter operative time (171.0±41.5 vs 242.6±87.3 min, P<0.05), shorter time to first flatus (3.3±0.9 vs 4.3±0.7 d, P<0.05), and lower cost (62148.1±8403.5 vs 88430.6±29408.6 yuan, P<0.05), but longer anastomosis time (36.1±5.4 vs 28.7±4.9 min, P<0.05) and drainage duration (27.5d[19.5,34.3] vs 12.0d[7.0,29.0], P<0.05). Blood loss (50.0ml[42.5,100.0] vs 100.0ml[50.0,100.0]) and hospital stay (12.3±5.6d vs 18.2±16.1d) were comparable (P>0.05). Overall complication rates were 60% (PDEA: 6/10, all Grade B pancreatic fistulas, 1 abdominal infection, 1 acute pancreatitis) and 28.6% (PJ: 6/21, 1 lymphatic fistula, 5 Grade B fistulas, 3 infections, 1 hemorrhage). Grade 3a complication rates were similar (12.5% vs 9.5%, P=1.000). Pancreatic fistula distribution differed significantly (P<0.05). New/worsened diabetes (0% vs 14.3%) and steatorrhea (0% vs 4.8%) occurred only in PJ, but differences were not significant (P>0.05).

Preliminary findings suggest LMP with PDEA is feasible and safe in selected patients with proficient technique, but requires further validation of advantages.