Abstract:

With the development of laparoscopic techniques, laparoscopic pancreaticoduodenectomy has been widely applied. Reconstruction of the pancreatic stump is the challenging and key step of this procedure, which is directly associated with the occurrence of a series of complications, such as postoperative pancreatic fistula, etc. At present, multiple approaches have been employed to reconstruct pancreatic stump, whereas none of these procedures can completely avoid the incidence of pancreatic fistula. In this article, the development of pancreaticojejunostomy was reviewed, and the advantages and disadvantages of common pancreaticojejunostomy patterns were illustrated based on our surgical experience. Subsequently, a novel pancreaticojejunostomy pattern designed and employed by our team was introduced, namely, the end-to-side pancreaticojejunostomy with pancreatic binding and interlocking, and the future development of pancreaticojejunostomy were finally discussed. This study aims to help clinicians to be familiar with different patterns of pancreaticojejunostomy, and understand appropriate application scenarios of each approach, thereby assisting clinicians to make more appropriate surgical decisions, reduce the risk of postoperative complications and improve clinical prognosis of patients.

Key words: Pancreaticojejunal anastomosis, Laparoscopic pancreatoduodenectomy (LPD), Postoperative pancreatic fistula (POPF)