The application of double layer continuous suture in pancreatic-jejunum anastomosis underwent pancreatoduodenectomy

Objective To investigate the application value of double-layer continuous suture in pancreatic jejunum anastomosis of pancreatoduodenectomy (PD). Methods A retrospective analysis of 114 consecutive patients (67 men and 47 women) who underwent PD from June 2012 to July 2013 were conducted. There were 79 patients who were treated by double-layer continuous suture technique and 35 patients by double-layer interrupted suture technique. The incidence of pancreatic fistula and other complications after PD with two different suture techniques were compared. Results The operation time of double-layer continuous suture group and double-layer interrupted suture group is respectively (284±5) and (288±7) mins, the intraoperative bleeding volume is respectively (236±29) and (282±49) ml, the differences between two groups were no statistical significance. The postoperative fasting time in two group was respectively (7.8±0.5) and (9.7± 0.5) days, the length of hospital stay time was respectively (14.0±1.0) and (17.2±10.0) days, the incidence of postoperative pancreatic fistula (POPF) was respectively 17.1%(6/35) and 39.2%(31/79), the differences between two groups were statistically significant(all P<0.05). Grade A POPF was found in 4 patients (11.4%) from the double-layer continuous suture group and in 5 patients (6.3%) from the double-layer interrupted suture group. Grade B POPF was identified only in 1 patients (2.9%) from the double-layer continuous suture group and in 23 patients (29.1%) from the double-layer interrupted suture group. The presence of Grade C POPF was only documented in 1 patient from the double-layer continuous suture group and in 3 patients from the interrupted suture group. Conclusions Continuous suture can be safely used in the duct-to-mucosa pancreatojejunostomy. The double-layer continuous suture can be more effective in reducing pancreatic fistula, improving the feeding time, and reducing the length of hospital stay, and it is worthy of clinical popularization and application. Key words: Pancreatoduodenectomy; Pancreaticojejunostomy; Suture techniques