The application value of "retrocolic approach, artery priority, uncinate process first" in laparoscopic pancreaticoduodenectomy

Abstract

Abstract Purpose The aim of this study is to explore the application value of " retrocolic approach, artery priority, uncinate process first " in laparoscopic pancreaticoduodenectomy, and to elaborate other common approaches. Methods We retrospectively analyzed the clinical data of 100 patients who underwent laparoscopic pancreaticoduodenectomy using this approach in our hospital from January 2018 to October 2018. We used SPSS22.0 for statistical analysis. Measurement data were expressed as OR M (Q25-Q75), and count data were expressed as frequency and rate. Results The average operation time was 267.82 ± 49.18 minutes, the average intraoperative blood loss was 165.30 ± 100.49ml, and 17 patients received blood transfusion. The average time of gastric tube removal was 5.67 ± 2.95 days, and the average time of eating was 5.32 ± 2.79 days. Postoperative complications occurred in 22 patients, including pancreatic fistula (n = 12), biliary fistula (n = 5), delayed gastric emptying (n = 2), intestinal obstruction (n = 1), gastrointestinal fistula (n = 1), postoperative bleeding (n = 8), abdominal infection (n = 9), pulmonary infection (n = 6), and reoperation (gastroscopy) (n = 8). The average length of hospital stay was 16.79 ± 8.98 days, and one patient died (1.00%). The mean tumor size was 3.03 ± 2.41cm. The mean number of lymph nodes dissected was 11.77 ± 5.66, and the mean number of positive lymph nodes was 1.10 ± 1.81. Conclusions The " retrocolic approach, artery priority, uncinate process first " approach shorted the operation time, reduced intraoperative blood loss and surgical complications. It is a safe, rapid and effective approach, which is worthy of further clinical promotion and application.