Double Half Purse-String Sutures Plus “8” Pattern of Stitching for Prevention of Duodenal Stump Fistula after Laparoscopic Gastrectomy

作者：Qiancheng Wang, Zeshen Wang, Zeshen Wang, Zeshen Wang, Shiyang Jin, Yuming Ju, Pengcheng Sun, Yuzhe Wei, Guanyu Zhu, Kuan Wang, Kuan Wang · 发表于：Journal of Laparoendoscopic & Advanced Surgical Techniques · 年份：2024 · DOI：10.1089/lap.2024.0113 · 被引用次数：4 · 研究领域：Esophageal and GI Pathology、Gastric Cancer Management and Outcomes、Bariatric Surgery and Outcomes

Background: Duodenal stump fistula represents an infrequent but serious complication after laparoscopic radical gastrectomy with Billroth II or Roux-en-Y reconstruction for gastric cancer. The present study was designed to evaluate the effectiveness of laparoscopic double half purse-string sutures plus “8” pattern of stitching for reinforcement of duodenal stump. Methods: The data of patients undergoing laparoscopic radical gastrectomy with Billroth II or Roux-en-Y reconstruction were retrospectively analyzed between August 2022 and June 2023. According to the different reinforcement methods of duodenal stump, included patients were subdivided into three groups as follows: Group A, duodenal stump was treated with double half purse-string sutures plus “8” pattern of stitching; Group B, duodenal stump was reinforced by continuous suture using a barbed suture; and Group C, duodenal stump without any additional processing. The incidences of duodenal stump fistula between three groups were documented and compared. Moreover, the independent risk factors associated with duodenal stump fistula were analyzed using the logistic regression analysis. Results: No postoperative duodenal stump fistula occurred in Group A, which was significantly different from Group B and Group C ( P = .007). In the multivariate analysis, age (odds ratio [OR], 1.191; 95% confidence interval [CI], 1.088–1.303), body mass index (OR, 0.824; 95% CI, 0.727–0.935), and American Society of Anesthesiologists score ...