Effect of Blumgart anastomosis in prevention and treatment of pancreatic fistula after pancreaticoduodenectomy

Objective To investigate the effect of Blumgart anastomosis( BA) on pancreatic fistula( PF) and other complications after pancreaticoduodenectomy. Methods The clinical data of 190 patients who underwent pancreaticoduodenectomy in our hospital from January2005 to December 2011 were analyzed retrospectively. The patients were divided into three groups,with 55 patients in the BA group,65 patients in the duct- to- mucosa anastomosis group,and 70 patients in the invaginated pancreaticojejunostomy group. The incidence rates of PF and other complications after different methods of anastomosis were compared. The chi- square test was applied for comparison of the incidence of complications between groups. Results No deaths occurred during surgery. The incidence rate of postoperative complications was48. 4%( 92 /190),and that of PF was 20. 5%( 39 /190),with 5. 5%( 3 /55) in the BA group,20%( 13 /65) in the duct- to- mucosa anastomosis group,and 32. 9%( 23 /70) in the invaginated pancreaticojejunostomy group. In the pancreatic duct with a diameter of < 3mm,the incidence rate of PF showed a significant difference between the three groups( χ2= 6. 089,P < 0. 05),while in the pancreatic duct with a diameter of ≥3 mm,there was no significant difference in PF between the three groups( χ2= 5. 436,P < 0. 05). Conclusion BA is a safe,simple,and time- saving technique and can reduce the incidence of PF,which is worthy of clinical application.