Application of a modified Chen's pancreaticojejunostomy to laparoscopic pancreaticoduodenectomy

He Long; Cui Jing; Zhou Xiaoxiao; Peng Tao; Zhao Chuanbing; Lu Yu; Gao Antong; Yin Tao

doi:10.3969/j.issn.1003-5591.2025.01.004

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Application of a modified Chen's pancreaticojejunostomy to laparoscopic pancreaticoduodenectomy

更新时间：2026-11-05

- Application of a modified Chen's pancreaticojejunostomy to laparoscopic pancreaticoduodenectomy
- J Abdominal Surg Vol. 38, Issue 1, Pages: 15-19(2025)
- 作者机构：
  
  华中科技大学同济医学院附属协和医院胰腺外科，湖北武汉 430022
- 作者简介：
  
  Yin Tao， Email：ytwhun@hust.edu.cn
- 基金信息：
- DOI：10.3969/j.issn.1003-5591.2025.01.004
  CLC： R615
- Received：13 December 2024，
  
  Published：22 February 2025
- 稿件说明：
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何龙,崔静,周笑笑等.陈氏胰肠吻合改良法在腹腔镜胰十二指肠切除术中的应用[J].腹部外科,2025,38(01):15-19.

He Long,Cui Jing,Zhou Xiaoxiao,et al.Application of a modified Chen's pancreaticojejunostomy to laparoscopic pancreaticoduodenectomy[J].J Abdominal Surg,2025,38(01):15-19.
何龙,崔静,周笑笑等.陈氏胰肠吻合改良法在腹腔镜胰十二指肠切除术中的应用[J].腹部外科,2025,38(01):15-19. DOI： 10.3969/j.issn.1003-5591.2025.01.004.

He Long,Cui Jing,Zhou Xiaoxiao,et al.Application of a modified Chen's pancreaticojejunostomy to laparoscopic pancreaticoduodenectomy[J].J Abdominal Surg,2025,38(01):15-19. DOI： 10.3969/j.issn.1003-5591.2025.01.004.

摘要

目的

探讨陈氏胰肠吻合改良法在腹腔镜胰十二指肠切除术中的应用价值。

方法

回顾性收集2023年1月至2024年10月于华中科技大学同济医学院附属协和医院作者团队收治的121例腹腔镜胰十二指肠切除术病人资料，其中传统

手术组63例，陈氏胰肠吻合改良组（改良手术组）58例，统计分析病人的性别、年龄、体重指数、手术时间、胰肠吻合时间、术中出血量、术后住院时间以及是否出现术后胰瘘、腹腔感染、腹腔出血、胃肠功能障碍、死亡等情况，并根据改良胰瘘风险评分系统（alternative pancreatic fistula risk score system，a‑FRS）筛选胰瘘中高风险人群，比较在胰瘘中高风险人群中两种手术后胰瘘发生的风险。符合正态分布的计量资料以

表示，非正态分布资料以四分位数［

（

，

）］表示；计数资料采用例数表示。

结果

改良手术组与传统手术组相比，手术时间较短［（311.8±55.0） min比（357.5±84.5） min，

=0.001］，胰肠吻合时间也较短［15.5 （13.8，18.0） min比26.0 （23.0，29.0） min，

0.001］，临床相关术后胰瘘发生率较低［3.4%（2/58）比15.9%（10/63），

=0.022］，而两组间病人年龄、性别、体重指数、胰瘘中高风险比例、术中出血量、术后住院时间差异均无统计学意义（均

0.05），腹腔感染、腹腔出血、胃肠功能障碍发生率差异均无统计学意义（均

0.05），两组均未出现围手术期死亡。根据a-FRS筛选出胰瘘中高风险人群62例，其中传统手术组中有34例，改良手术组中有28例，改良手术组胰瘘中高风险病人的手术时间、胰肠吻合时间仍较传统手术组胰瘘中高风险病人短（均

0.05），改良手术组胰瘘中高风险病人术后胰瘘发生率仍低于传统手术组胰瘘中高风险病人（

=0.036）。

结论

陈氏胰肠吻合改良法操作简单，胰肠吻合时间短，胰瘘发生率低，对胰瘘中高风险病人同样适用。

Abstract

Objective

This study aims to assess the effectiveness of a modified Chen's pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy （LPD）.

Methods

A retrospective analysis was conducted on the clinical data of 121 patients who underwent LPD at Union Hospital， Tongji Medical College， Huazhong University of Science and Technology between January 2023 and October 2024. The patients were divided into two groups： traditional surgery group （63 patients） and modified Chen's pancreaticojejunostomy （modified surgery group）（58 patients）. Gender， age， body mass index （BMI）， operation time， pancreatojejunostomy time， intraoperative blood loss， postoperative hospital stay， and the incidence of postoperative complications like pancreatic fistula， abdominal infection， intra-abdominal bleeding， gastrointestinal dysfunction， and mortality were compared between groups. Additional

ly， moderate-to-high risk patients for pancreatic fistula were identified using the alternative pancreatic fistula risk score system （a-FRS）. The risk of pancreatic fistulas between groups was compared. Quantitative data adhering to a normal distribution were expressed as

https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=73890760&type=

2.45533323

https://html.publish.founderss.cn/rc-pub/api/common/picture?pictureId=73890762&type=

7.11199999

； otherwise， they were expressed as quartiles ［

（

，

）］. Count data were presented as the number of instances.

Results

Patients in the modified surgery group showed significantly shorter operation time（311.8±55.0 min vs. 357.5±84.5 min，

=0.001）and pancreatojejunostomy time ［15.5 （13.8，18.0） min vs. 26.0 （23.0，29.0） min，

0.001］ compared to the traditional surgery group. The incidence of clinically relevant postoperative pancreatic fistula was also significantly lower in the modified surgery group than in the traditional surgery group ［3.4% （2/58） vs. 15.9% （10/63），

=0.022］. There were no significant differences between the two groups in the age， gender， BMI， proportion of patients at moderate-to-high risk for pancreatic fistula， intraoperative blood loss， postoperative hospital stay， rates of abdominal infection， intra-abdominal bleeding， and gastrointestinal dysfunction （

0.05）. There were no perioperative deaths in both groups. Among the 62 patients at a moderate-to-high risk for pan

creatic fistula using the a-FRS model （34 in the traditional surgery group and 28 in the modified surgery group）， those in the modified surgery group still showed significantly shorter operation and pancreatojejunostomy times （

0.05） and a lower incidence of postoperative pancreatic fistula （

=0.036）.

Conclusion

The modified Chen's pancreaticojejunostomy simplifies the procedure， decreases the duration of pancreatojejunostomy， and reduces the occurrence of pancreatic fistulas. This technique is effective for patients assessed as having a moderate-to-high risk of developing pancreatic fistulas.

关键词

Keywords

references

Malgras B ， Dokmak S ， Aussilhou B ， et al . Management of postoperative pancreatic fistula after pancreaticoduodenectomy ［J］. J Visc Surg ， 2023 ， 160 （ 1 ）： 39 - 51 . DOI： 10.1016/j.jviscsurg.2023.01.002 http://dx.doi.org/10.1016/j.jviscsurg.2023.01.002 .

陈孝平 . 陈氏贯穿胰腺连续缝合法行肠壁内翻套入式胰肠吻合术的几点体会［J］. 腹部外科， 2019 ， 32 （ 2 ）： 77 - 79 . DOI： 10.3969/j.issn.1003-5591.2019.02.001 http://dx.doi.org/10.3969/j.issn.1003-5591.2019.02.001 .

Cesaretti M ， Bifulco L ， Costi R ， et al . Pancreatic resection in the era of laparoscopy：state of art.A systematic review ［J］. Int J Surg ， 2017 ， 44 ： 309 - 316 . DOI： 10.1016/j.ijsu.2017.07.028 http://dx.doi.org/10.1016/j.ijsu.2017.07.028 .

程诗博，赵传兵，吴遒，等 . 基于集成机器学习构建胰十二指肠术后胰瘘风险预测模型及其验证［J］. 中华外科杂志， 2024 ， 62 （ 10 ）： 929 - 937 . DOI： 10.3760/cma.j.cn112139-20240411-00180 http://dx.doi.org/10.3760/cma.j.cn112139-20240411-00180 .

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

朱淑婷，郑兰平，张频，等 . 胰十二指肠切除术后患者胰瘘风险预测模型的系统评价［J］. 中华肝胆外科杂志， 2024 ， 30 （ 9 ）： 691 - 698 . DOI： 10.3760/cma.j.cn113884-20240419-00111 http://dx.doi.org/10.3760/cma.j.cn113884-20240419-00111 .

刘伟康，陈依然，杨尹默 . 胰腺癌围术期热点问题与管理策略［J］. 协和医学杂志， 2024 ， 15 （ 4 ）： 740 - 746 . DOI： 10.12290/xhyxzz.2024-0407 http://dx.doi.org/10.12290/xhyxzz.2024-0407

Qin R ， Kendrick ML ， Wolfgang CL ， et al . International expert consensus on laparoscopic pancreaticoduodenectomy ［J］. Hepatobiliary Surg Nutr ， 2020 ， 9 （ 4 ）： 464 - 483 . DOI： 10.21037/hbsn-20-446 http://dx.doi.org/10.21037/hbsn-20-446 .

毛天阳，谢青云，赵欣，等 . 胰肠吻合及其改良对于术后胰瘘影响的研究现状［J］. 腹部外科， 2024 ， 37 （ 5 ）： 378 - 383 . DOI： 10.3969/j.issn.1003-5591.2024.05.013 http://dx.doi.org/10.3969/j.issn.1003-5591.2024.05.013

洪德飞，刘亚辉，张宇华，等 . 腹腔镜胰十二指肠切除术中“洪氏一针法”胰管空肠吻合的临床应用［J］. 中华外科杂志， 2017 ， 55 （ 2 ）： 136 - 140 . DOI： 10.3760/cma.j.issn.0529-5815.2017.02.012 http://dx.doi.org/10.3760/cma.j.issn.0529-5815.2017.02.012 .

张威，王英超，刘凯，等 . 双荷包缝合法胰肠吻合在完全腹腔镜胰十二指肠切除术中的应用体会［J］. 临床肝胆病杂志， 2016 ， 32 （ 5 ）： 921 - 924 . DOI： 10.3969/j.issn.1001-5256.2016.05.023 http://dx.doi.org/10.3969/j.issn.1001-5256.2016.05.023 .

陈孝平 . 贯穿胰腺纵向“U”形缝合法行空肠内翻套入式胰肠吻合术［J］. 腹部外科， 2017 ， 30 （ 3 ）： 153 - 154 . DOI： 10.3969/j.issn.1003-5591.2017.03.001 http://dx.doi.org/10.3969/j.issn.1003-5591.2017.03.001 .

Chen XP ， Huang ZY ， Lau JWY ， et al . Chen's U-suture technique for end-to-end invaginated pancreaticojejunostomy following pancreaticoduodenectomy ［J］. Ann Surg Oncol ， 2014 ， 21 （ 13 ）： 4336 - 4341 . DOI： 10.1245/s10434-014-3823-2 http://dx.doi.org/10.1245/s10434-014-3823-2 .

宗可，陈文辉，罗凯，等 . 腹腔镜胰十二指肠切除术的学习曲线分析［J］. 中华胰腺病杂志， 2023 ， 23 （ 4 ）： 299 - 301 . DOI： 10.3760/cma.j.cn115667.20220704-00101 http://dx.doi.org/10.3760/cma.j.cn115667.20220704-00101 .

Wang M ， Peng B ， Liu J ， et al . Practice patterns and perioperative outcomes of laparoscopic pancreaticoduodenectomy in China：a retrospective multicenter analysis of 1029 patients ［J］. Ann Surg ， 2021 ， 273 （ 1 ）： 145 - 153 . DOI： 10.1097/sla.0000000000003190 http://dx.doi.org/10.1097/sla.0000000000003190 .

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