Hill Publishing Group | contact@hillpublisher.com

Hill Publishing Group

Location:Home / Journals / International Journal of Clinical and Experimental Medicine Research /


Comparative Study on the Incidence of Pancreatic Fistula and Biliary Fistula in Patients after Pancreaticoduodenectomy with Two Gastric Tube Placement Sites

Date: July 29,2022 |Hits: 137 Download PDF How to cite this paper

Bo Yang

Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China.

*Corresponding author: Bo Yang


Objective: To investigate the effect of gastric tube placement on pancreatic fistula and biliary fistula after pancreaticoduodenectomy. Methods: The clinical data of 77 patients undergoing pancreaticoduodenectomy admitted from November 2014 to December 2020 were retrospectively analyzed. According to the location of gastric tube, they were divided into group A (31 cases) and group B (46 cases). In group A, the gastric tube was inserted into the jejunum input loop through the gastrointestinal anastomosis until near the bilioenteric anastomosis; In group B, the gastric tube was inserted into the jejunum input loop about 5cm through the gastrointestinal anastomosis. The incidence of postoperative pancreatic fistula and biliary fistula complications was compared between the two groups. Results: There were no significant differences in operative time, intraoperative blood loss and gastric tube indwelling time between the two groups (P>0.05). The incidence of pancreatic fistula and biliary fistula in group A was lower than that in group B, and the difference was statistically significant (P<0.05). Conclusion: The placement of gastric tube into jejunal input loop through gastrointestinal anastomosis to the vicinity of biliary anastomosis can significantly reduce the incidence of pancreatic fistula and biliary fistula after pancreaticoduodenectomy, which has certain clinical reference value.


[1] Karim, S. A. M., Abdulla, K. S., Abdulkarim, Q. H., Rahim, F. H. (2018). The outcomes and complications of pancreaticoduo-denectomy (Whipple procedure): Cross sectional study. Int J Surg., 2018 Apr., 52: 383-387. doi: 10.1016/j.ijsu.2018.01.041. 

[2] Pugalenthi, A., Protic, M., Gonen, M., Kingham, T. P., Angelica, M. I., et al. (2016). Postoperative complications and overall survival after pancreaticoduodenectomy for pancreaticductal adenocarcinoma [J]. J Surg Oncol., 2016, 113(2):188-193. doi: 10.1002/jso.24125.

[3] Park, J. S., Kim, J. Y., Kim, J. K., Yoon, D. S. (2016). Should Gastric Decompression be a Routine Procedure in Patients Who Undergo Pylorus-Preserving Pancreatoduodenectomy? World J Surg., 2016 Nov., 40(11): 2766-2770. doi: 10.1007/s00268-016-3604-0.

[4] Gaignard, E., Bergeat, D., Courtin-Tanguy, L., Rayar, M., Merdrignac, A., et al. (2018). Is systematic nasogastric decompression after pancreaticoduodenectomy really necessary? Langenbecks Arch Surg, 2018, 403(5): 573-580. doi: 10.1007/s00423-018-1688-8.

[5] Paredes, A. Z., Hyer, J. M., Beal, E. W., Bagante, F., Merath, K., et al. (2019). Impact of skilled nursing facility quality on postoperative outcomes after pancreatic surgery. Surgery, 2019 Jul., 166(1): 1-7. doi: 10.1016/j.surg.2018.12.008.

[6] Bassi, C., Marchegiani, G., Dervenis, C., Sarr, M., Abu Hilal, M., et al. (2017). The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery, 2017 Mar, 161(3): 584-591.doi: 10.1016/j.surg.2016.11.014.

[7] Schaible, A., Schemmer, P., Hackert, T., et al. (2017). Location of a biliary leak after liver resection determines success of endoscopic treatment [J]. Surg Endosc, 2017, 31(4): 1814-1820.

[8] Malleo, G., Vollmer, C. M. Jr. (2016). Postpancreatectomy Complications and Management. Surg Clin North Am., 2016 Dec, 96(6): 1313-1336. doi: 10.1016/j.suc.2016.07.013. 

[9] Bai, X., Zhang, Q., Gao, S., Lou, J., Li, G., et al. (2016). Duct-to-Mucosavs Invagination for Pancreaticojejunostomy after Pancreaticoduodenectomy: A Prospective, Randomized Controlled Trial from a Single Surgeon. J Am Coll Surg., 2016 Jan, 222(1): 10-8. doi: 10.1016/j.jamcollsurg.2015.10.003.

[10] Jin, K., Zhou, H., Zhang, J., Wang, W., Sun, Y., et al. (2015). Systematic review and meta-analysis of somatostatin analogues in the prevention of postoperative complication after pancreaticoduodenectomy. Dig Surg., 2015, 32(3): 196-207. doi: 10.1159/000381032.

[11] Akgul, O., Merath, K., Mehta, R., Hyer, J. M., Chakedis, J., et al. (2019). Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy-Stratification of Patient Risk. J Gastrointest Surg., 2019 Sep, 23(9): 1817-1824. doi: 10.1007/s11605-018-4045-x. Epub 2018 Nov 26. 

[12] Lee, C. W., Pitt, H. A., Riall, T. S., Ronnekleiv-Kelly, S. S., Israel, J. S., et al. (2014). Low drain fluid amylase predicts absence of pancreatic fistula following pancreatectomy. J Gastrointest Surg., 2014 Nov, 18(11): 1902-10. doi: 10.1007/s11605-014-2601-6.

[13] Yang, J., Huang, Q., Wang, C. (2015). Postoperative drain amylase predicts pancreatic fistula in pancreatic surgery: A systematic review and meta-analysis. Int J Surg., 2015 Oct, 22: 38-45. doi: 10.1016/j.ijsu.2015.07.007.

[14] Wang, Y. C., Szatmary, P., Zhu, J. Q., Xiong, J. J., Huang, W., et al. (2015). Prophylactic intra-peritoneal drain placement following pancreaticoduodenectomy: a systematic review and meta-analysis. World J Gastroenterol, 2015 Feb 28, 21(8): 2510-21. doi: 10.3748/wjg.v21.i8.2510.

[15] Marchegiani, G., Andrianello, S., Salvia, R., Bassi, C. (2019). Current Definition of and Controversial Issues Regarding Postoperative Pancreatic Fistulas. Gut Liver, 2019 Mar 15, 13(2): 149-153. doi: 10.5009/gnl18229. 

[16] Strobel, O., Neoptolemos, J., Jäger, D., Büchler, M. W. (20190. Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol., 2019 Jan; 16(1): 11-26. doi: 10.1038/s41571-018-0112-1. 

[17] Jeune, F., Coriat, R., Prat, F., Dousset, B., Vaillant, J. C., et al. (2019). Pancreatic cancer surgical management. Presse Med., 2019 Mar, 48(3 Pt 2): e147-e158. doi: 10.1016/j.lpm.2019.02.027.

[18] Guilbaud, T., Birnbaum, D. J., Loubière, S., Bonnet, J., Chopinet, S., et al. (2017). Comparison of different feeding regimes after pancreatoduodenectomy - a retrospective cohort analysis. Nutr J., 2017 Jul 4, 16(1): 42. doi: 10.1186/s12937-017-0265-2. 

[19] Yang, J., Huang, Q., Wang, C. (2015). Postoperative Drain Amylase Predicts Pancreatic Fistula in Pancreatic Surgery: A Systematic Review and Meta-Analysis [J]. Int J Surg, 2015, 22: 38-45. 10.1016/j.ijsu.2015.07.007.

[20] Jang, J. Y., Chang, Y. R., Kim, S. W., Choi, S. H., et al.(2016). Randomized multicentre trial comparing external and internal pancreatic stenting during pancreaticoduodenectomy. Br J Surg., 2016 May, 103(6): 668-675. doi: 10.1002/bjs.10160.

[21] Lyu, Y., Wang, B., Cheng, Y., Xu, Y., Du, W. B. (2020). Comparison of surgical outcomes between isolated pancreaticojejunostomy, isolated gastrojejunostomy, and conventional pancreaticojejunostomy after pancreaticoduodenectomy: a systematic review and meta-analysis. BMC Gastroenterol., 2020 Aug 20, 20(1): 279. doi:10.1186/s12876-020-01415-8.

[22] Takeishi, K., Maeda, T., Yamashita, Y., Tsujita, E., Itoh, S., et al. (2016). A Cohort Study for Derivation and Validation of Early Detection of Pancreatic Fistula After Pancreaticoduodenectomy. J Gastrointest Surg., 2016 Feb, 20(2): 385-91. doi: 10.1007/s11605-015-3030-x.

How to cite this paper

Comparative Study on the Incidence of Pancreatic Fistula and Biliary Fistula in Patients after Pancreaticoduodenectomy with Two Gastric Tube Placement Sites

How to cite this paper: Bo Yang. (2022) Comparative Study on the Incidence of Pancreatic Fistula and Biliary Fistula in Patients after Pancreaticoduodenectomy with Two Gastric Tube Placement Sites. International Journal of Clinical and Experimental Medicine Research6(3), 295-300.

DOI: http://dx.doi.org/10.26855/ijcemr.2022.07.010

Volumes & Issues

Free HPG Newsletters

Add your e-mail address to receive free newsletters from Hill Publishing Group.

Contact us

Hill Publishing Group

8825 53rd Ave

Elmhurst, NY 11373, USA

E-mail: contact@hillpublisher.com

Copyright © 2019 Hill Publishing Group Inc. All Rights Reserved.