Other anastomosis

Further reconstruction of the continuity of the digestive tract includes end-to-side cholangiojejunostomy and end-to-side gastrojejunostomy. The gastrojejunostomy was carried out behind the transverse colon. A nasogastric tube with multi-lateral hole was placed in the input loop in all patients. After surgical reconstruction during PD, two drains were placed in the vicinity of the pancreaticojejunostomy and the cholangiojejunostomy without suction. The drainage tube remained intact 7–9 days after operation. The appearance and amount of drainage fluid were recorded daily, and drainage samples was collected on days 1–3 and 7 to test amylase level. For suspected clinical POPF, CT scan was performed to evaluate the situation of intraperitoneal pancreatic leakage and help to determine the next treatment. All patients took octreotide for 3 days after operation. The amylase level in the drainage fluid is an indicator to decide when to stop octreotide. Parenteral nutrition was started on postoperative day 0 and continued until the patient tolerated oral feeding.