Abstract:

In recent years, laparoscopic radical gastrectomy has gradually become the main surgical method for non-advanced gastric cancer, and its complications are gradually recognized. Postoperative pancreatic fistula (POPF), as a serious complication, has an incidence of 5.3%- 11.8%, which is higher than that of open surgery.This may be closely related to the limitations of laparoscopic operation and blunt pancreatic injury during operation. Preoperative abdominal CT P-A length, UP-CA angle, BMI, and C-reactive protein levels on the third day after operation were positively correlated with the incidence of POPF. An ultrasound knife with temperature sensing function and visualization system of pancreatic exudation can help prevent POPF. However, robotic surgery and the use of somatostatin before surgery can not reduce the incidence of POPF.Methods should be improved when dissecting supra-pancreatic lymph nodes, such as "left approach" or "middle approach of pancreas" , "T-gauze" or tissue suspension device can reduce pancreatic injury, and "biological glue" spraying on pancreatic wounds can reduce pancreatic fluid exudation. After operation, the drainage tube was maintained unobstructed. In case of pancreatic fistula, double cannula irrigation and somatostatin continuous micropump were used. This article mainly discusses the causes of POPF in laparoscopic radical gastrectomy and perioperative prevention strategies, hoping to provide some clues for the diagnosis and treatment of POPF.

Key words: Laparoscopy, Gastric carcinoma, Postoperative pancreatic fistula, Prevention