Summarize the experience of two-needle double-layer pancreatoenterostomy in laparoscopic pancreaticoduodenectomy (LPD), and explore its safety and effectiveness.

Retrospective analysis of 38 hospitalized patients with LPD at the Digestive Minimally Invasive Center, the Second Affiliated Hospital of Baotou Medical College from October 2017 to October 2022. The observation group (group A=20 cases) used two-needle double-layer continuous pancreatic duct jejunal mucosal anastomosis, while the control group (group B=18 cases) used intermittent pancreatic duct jejuna mucosal anastomosis. The time of pancreatoenterostomy, surgical time, intraoperative bleeding, postoperative pancreatic leakage, reoperation, and other postoperative complications were observed in both groups.

All 38 patients successfully completed the operation.Pancreato-enterostomy time: [group A (39.25±6.89) min vs. group B (44.89±7.55) min, P=0.021]; Operation time: [group A (293.15±46.61) min vs. group B (314.44±56.80) min, P=0.211]; Peroperative bleeding: [group A (165.75±18.44) ml vs. group B (169.44±14.74) ml, P=0.503]; Grade A pancreatic fistula 2 cases in group A and 7 cases in group B, P=0.043; Grade B pancreatic fistula 3 cases in group A and 3 cases in group B, P=0.616, no grade C pancreatic leakage in both groups; There was 1 case of leakage in both groups, 1 case of abdominal infection and lung infection, and no postoperative bleeding in both groups; 0 cases in the gastric emptying disorder observation group and 1 case in the control group; Mean extubation time of prepancreatic enteric drainage tube: [group A (16.8±6.2) d vs. group B (22.3±9.1) d, P=0.043]; The mean extubation time of posterior bilioenteric drainage tube: [group A (8.4±3.1) d vs. group B (9.2±3.8) d, P=0.467]; average length of hospital stay: [group A (18.1±7.4) d vs. group B (18.7±7.9) d, P=0.787]; open eating time all was 5 days; no second operation was performed in both groups, and no death occurred in both groups within 30 days after operation. The statistical results: The time of pancreatoenterostomy, the incidence of pancreatic fistula (Grade A) and the mean extubation time of anterior pancreaticoenteric drainage tube in the observation group were significantly lower than those in the control group, and the differences between the two groups were significant (P<0.05). Pancreatic fistula (grade B/C) and other observation indicators were not statistically different between the two groups (P>0.05).

Two-needle double-layer pancreatoenterostomy is safe, effective, simple and easy to learn in LPD, and worthy of clinical application and promotion.