Application research on “one thread” pancreaticojejunostomy procedures in pancreaticoduodenectomy under the guidance of three-dimensional visualization        XIANG Nan，FANG Chi-hua，WU Tian-chong，et al. Department of Hepatobiliary Surgery，Zhujiang Hospital，Southern Medical University，Guangzhou 510282，China
Corresponding author：FANG Chi-hua，E-mail：fangch_dr@126.com
Abstract    Objective    To study the value of application on “one thread” pancreaticojejunostomy procedures in pancreaticoduodenectomy to prevent pancreatic fistula under the guidance of three-dimensional（3D）visualization. Methods    The clinical data of 26 cases of pancreaticoduodenectomy between January 2012 and November 2013 in Zhujiang Hospital of Southern Medical University were analyzed retrospectively. They were underwent “one  thread” pancreaticojejunostomy procedures in pancreaticoduodenectomy based on the liver，biliary tract，pancreas 3D reconstruction and surgical planning by the medical image three dimensional visualization system (MI-3DVS). Results The measurements of the pancreatic duct diameter and pancreatic stump diameter were （2.9±1.3） mm and （3.8±0.4） cm by the preoperative 3D analysis. There were successfully implemented the “one thread” pancreaticojejunostomy procedures in 26 cases of pancreaticoduodenectomy. The pancreaticojejunostomy procedures time was （15.4±1.2） min. There were 2 cases of A grade pancreaticoenterostomy fistula. No operative death happened and no complications such as abdominal bleeding and bile leakage occurred in all cases. The lengths of postoperative hospital stay were（13.8±1.4）days. Conclusion    The “one thread” pancreaticojejunostomy procedures guided by three-dimensional visualization technology in pancreaticoduodenectomy has the characteristics of being more easily to operate，exactly in the anastomosis procedures and being fewer complications，which is an effective improvement way to prevent pancreatic fistula.