Causes of gastrointestinal anastomotic stenosis following pancreaticoduodenectomy among patients of pancreatic cancer

WEI Zhicheng; LIU Rong; WANG Chunxi

Abstract：Objective To investigate the causes of gastrointestinal anastomotic stenosis after pancreaticoduodenectomy for pancreatic cancer. Methods A case-control study method was employed to analyze retrospectively ninety-eight cases of pancreaticoduodenectomy performed at our department between December 2015 and October 2016. Among these patients, there were ten cases of gastrointestinal anastomotic stenosis. The ninety-eight patients were divided into two groups: the stenosis group and non-stenosis group. The general information, preoperative, intraoperative and postoperative clinical data of the two groups of patients were analyzed to identify the causes of stenosis. Results Logistic regression analysis showed that the size of the anastomotic stoma ranged from 4 to 6 cm (OR=0.837, P=0.001). The anastomotic stoma that was in the direction of gastrointestinal peristalsis (OR=0.917, P=0.001) and postoperative pancreatic fistula (OR=4.726, P<0.05) were factors that influenced the postoperative anastomotic stenosis after pancreaticoduodenectomy. The size of anastomotic stoma that ranged from 4 to 6 cm and anastomotic stoma that was in the direction of gastrointestinal peristalsis were protective factors while postoperative pancreatic fistula was a risk factor for anastomotic stenosis. Conclusion Efforts should be made to maintain the moderate size of anastomotic stoma, for too large or too small a stoma will lead to gastrointestinal anastomotic stenosis. Postoperative prevention and treatment of pancreatic fistula is an effective measure to prevent gastrointestinal anastomotic stenosis after pancreaticoduodenectomy.