Clinical feature and feasibility analysis of reconstructive surgery for pancreaticojejunal anastomotic stricture after pancreaticoduodenectomy
HE Jun-chuang
YAN Hong-xian
TIAN Jian-guo
WEI Si-dong
LIU Guang-bo
WANG Wei-wei
LI Ya-qi
ZHANG Ji-xiang
CHEN Guo-yong
Abstract：Objective To investigate the clinical manifestations,risk factors,and preventive measures of pancreaticojejunal anastomotic stricture(PJS)after pancreaticoduodenectomy(PD)and the feasibility of reconstructive surgery for pancreaticojejunostomy reconstruction.Methods The clinical data,diagnosis,treatment,and follow-up of 6 patients with PJS from January 2015 to January 2020 in People's Hospital of Zhengzhou University were retrospectively analyzed.Results The median time of symptoms occurrence of PJS was 19.7 months(8-60 months),which included epigastric pain(5/6,83.3％),abdominal distension(3/6,50.0％),steatorrhea(1/6,16.7％)and recurrent pancreatitis(1/6,16.7％).CT and magnetic resonance cholangiopancreatography(MRCP)showed stenosis of pancreaticoenteric anastomosis and distal pancreatic duct dilatation.Five patients underwent pancreaticojejunostomy reconstruction during the study period.The surgical procedures included:End-to-side re-pancreaticojejunostomy,pancreatic duct stone removal and pancreatic duct stent implantation,and side-to-side pancreaticojejunostomy.At a median follow-up of 32 months(23-44 months),5 patients had good symptom relief after reconstructive surgery,and 1 patient had recurrent pancreatitis with conservative management.Conclusion Pancreatic duct stent implantation and reliable pancreaticojejunostomy during PD procedure and reducing the incidence of POPF are important factors in reducing the incidence of PJS.Reconstruction of pancreaticoenteric anastomotic stoma is a safe and effective treatment for PJS,but it should be individualized.
Keywords：pancreaticoduodenectomypancreatico-jejunal anastomotic stricturereconstructive surgery
Publication Date：2024-02-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 205-210 )