title: Continuous suturing with two anterior layers reduces post-operative complications and hospitalization time in pancreaticoenterostomy.
abstract: BACKGROUND
  Most complications after pancreaticoduodenectomy (PD) were relation to pancreaticoenterostomy. We improved a new method of pancreaticoenterostomy that included the continuous suturing of the jejunum and the stump of the pancreas end-to-side with one layer posteriorly and two layers anteriorly. To evaluate the safety and efficiency of this new method, we introduced this retrospectively compared trial.
  
  
  METHODS
  We compared 45 patients who had undergone pancreaticoduodenectomy with either the regular interrupted suturing method or the new continuous mattress suturing method in our hospital from September 2011 to March 2014.
  
  
  RESULTS
  Although the total operation times were not reduced, the suturing time for the pancreaticoenterostomies in the continuous suture group (11.3 ± 1.8 min) was greatly reduced compared with that for the interrupted suture group (14.1 ± 2.9 min, p = 0.045). Importantly, the continuous mattress suturing method significantly decreased short-term post-operative complications, including pancreatic leakage (p = 0.042). Furthermore, shorter hospitalization times were observed in the continuous mattress suture group (12.3 ± 5.0 d) than in the interrupted suture group (24.2 ± 11.6 d, p = 0.000).
  
  
  CONCLUSIONS
  Continuous mattress suturing is a safe and effective pancreaticoenterostomy method that leads to reduced complications and hospitalization times.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital of Henan University of Science and Technology, 24 Jinghua Road, Luoyang, 471003, People's Republic of China.
authors.forename: Guoliang
authors.initials: G
authors.lastname: Yao
authors.affiliation: Department of General Surgery, The First Affiliated Hospital of Henan University of Science and Technology, 24 Jinghua Road, Luoyang, 471003, People's Republic of China.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Fan
authors.affiliation: Department of General Surgery, The First Affiliated Hospital of Henan University of Science and Technology, 24 Jinghua Road, Luoyang, 471003, People's Republic of China. 15237917026@163.com.
authors.forename: Jingming
authors.initials: J
authors.lastname: Zhai
mesh_terms: D006801:Humans; D007583:Jejunum / Q000601:surgery; D007902:Length of Stay; D061646:Operative Time; D010179:Pancreas / Q000601:surgery; D010193:Pancreaticojejunostomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D012189:Retrospective Studies; D013536:Suture Techniques
keywords: Continuous mattress suturing; Pancreatic leakage; Pancreaticoduodenectomy; Pancreaticoenterostomy