Application of split pancreatic drainage tube in laparoscopic pancreaticoduodenectomy

Abstract

Abstract Background Laparoscopic pancreaticoduodenectomy (LPD) is a classic surgical method for diseases, such as tumors at the lower end of the common bile duct, pancreatic head, and benign and malignant tumors of the duodenum. Postoperative pancreatic fistula (POPF) is one of the most serious complications of LPD. In this study, we introduced a separate stent drainage method to reduce the occurrence of grade B or C POPF and its related complications. Methods To reduce the incidence of grade B or C POPF and other complications after LPD, we applied a split pancreatic drainage tube combined with the characteristics of internal and external stent drainage. Between January 2018 and May 2022, 12 patients underwent placement of the split pancreatic drainage tube during LPD.Data on operation time, duration of pancreaticojejunostomy (PJ), intraoperative blood loss, first postoperative exhaust time, postoperative hospital stay, incidence of POPF and other complications were collected and analyzed. Results The average operation time was 280 ± 42 min, average time for PJ was 35 ± 6 min, and average estimated blood loss was 200 ± 40 mL. Biochemical leakage occurred in two patients (16.7%), whereas no grade B or C POPF, other related complications, and deaths occurred within 30 days after the operation. Conclusion Split pancreatic drainage tube effectively converts external stent drainage into internal stent drainage. It fully combines internal and external drainage characteristics, effectively reduces the incidence of postoperative POPF and other related complications of grade B or C, and provides a new choice for clinicians to make decisions.