One-layer versus two-layer duct-to-mucosa pancreaticojejunostomy after pancreaticoduodenectomy: study protocol for a randomized controlled trial

Shu-Bo Pan, Wei Geng, Da-Chen Zhou, Jiang-Ming Chen, Hong-Chuan Zhao, Fu-Bao Liu, Sheng-Xue Xie, Hui Hou, Yi-Jun Zhao, Kun Xie, Guo-Bin Wang, Xiao-Ping Geng, Shu-Bo Pan, Wei Geng, Da-Chen Zhou, Jiang-Ming Chen, Hong-Chuan Zhao, Fu-Bao Liu, Sheng-Xue Xie, Hui Hou, Yi-Jun Zhao, Kun Xie, Guo-Bin Wang, Xiao-Ping Geng

Abstract

Background: Although various pancreaticojejunal duct-to-mucosa anastomosis methods have been developed to reduce the postoperative risks of pancreaticoduodenectomy, pancreatic fistula remains the most serious complication with a high incident rate. The aim of this study is to compare the safety and effectiveness of one-layer and two-layer duct-to-mucosa pancreaticojejunostomy in patients undergoing pancreaticoduodenectomy.

Methods/design: In this study, adult patients who sign consent forms will be recruited and scheduled for elective pancreaticoduodenectomy. One hundred and fourteen patients will be included and randomized before pancreaticojejunal reconstruction and after resection of the lesion from the pancreatic or periampullary region. The primary efficacy endpoint is the incident rate of postoperative pancreatic fistula. Statistical analysis will be based on the intention-to-treat population. Patients will be followed up for 3 months by monitoring for complications and other adverse events.

Discussion: This prospective, single-center, randomized, single-blinded, two-group parallel trial is designed to compare one-layer with two-layer duct-to-mucosa anastomosis for pancreaticojejunal anastomosis during elective pancreaticoduodenectomy.

Trial registration: Clinical Trials.gov: NCT02511951 . Registered on 29 July 2015.

Keywords: Duct-to-mucosa; Pancreaticoduodenectomy; Pancreaticojejunostomy; Postoperative pancreatic fistula.

Figures

Fig. 1
Fig. 1
Flow chart according to CONSORT
Fig. 2
Fig. 2
The procedure of end-to-side one-layer duct-to-mucosa PJ anastomosis: the posterior suturing layer
Fig. 3
Fig. 3
The anterior suturing layer with duct-to-mucosa PJ anastomosis
Fig. 4
Fig. 4
The procedure of end-to-side two-layer duct-to-mucosa PJ anastomosis: the seromuscular layer
Fig. 5
Fig. 5
The procedure of two-layer duct-to-mucosa PJ anastomosis: duct-to-mucosa layer

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Source: PubMed

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