Relations between the post pancreatoduodenectomy pancreatic anastomotic hemorrhage and the length of pancreatic duct endoprosthesis placed in the jejunum

Objective To explore the relations between the post pancreatoduodenectomy pancreatic anastomotic hemorrhage and the length of pancreatic duct endoprosthesis placed in the jejunum.Methods From August 2006 to August 2011,63 patients underwent pancreaticoduodenectomy with the adopted child method for digestive tract reconstruction,while pancreaticojejunostomy reconstruction was divided into A,B,C groups.There were 22 cases in A group,and patients underwent pancreaticojejunostomy with anastomosis of the pancreatic stump into the jejunum strapping method,the length of pancreatic duct endoprosthesis placed in the jejunum was 15 cm; there were 21 cases in B group,and patients received the same operation as patients in group A,but the length of pancreatic duct endoprosthesis placed in the jejunum was 5 cm; there were 20 cases in C group,and patients received pancreatic stump and jejunal mucosa anastomosis,the length of pancreatic duct endoprosthesis placed in the jejunum was 5 cm.Results In group A,two cases (9.1％) of pancreatic anastomotic hemorrhage occurred,and patients were cured by conservative treatment.In group B,eight cases (38.1％) of pancreatic anastomotic hemorrhage occurred,and two cases died of gastrointestinal bleeding; 3 cases received surgical operation to stop bleeding,and 3 patients were cured by conservative treatment.There was no anastomotic hemorrhage occurred in group C.The bleeding times of group A and group B were about 15 days after surgery,the difference of incidence of anastomotic bleeding between the two groups was statistically significant (x2 =9.428,P =0.009).Conclusions Post pancreaticojejunostomy anastomotic hemorrhage is associated with short length of pancreatic duct endoprosthesis placed in the jejunum. Key words: Pancreatoduodenectomy ;  Panereatieojejunostomy ;  Postoperative hemorrhage ; Binding