摘要
AIM： To distinguish anastomotic from parenchymal leakage at duct-to-mucosa reconstruction of the pancreatic remnant. METHODS： We reviewed the charts of 68 pancreaticoduodenectomies performed between 5/2000 and 12/2005 with end-to-side duct-to-mucosa pancreatojejunostomy （PJ）. The results of pancreatography, as well as peripancreatic drain volumes, and amylase levels were analyzed. RESULTS： Of 68 pancreatojejunostomies, 48 had no leak by pancreatography and had low-drain amylase （normal）; eight had no pancreatographic leak but had elevated drain amylase （parenchymal leak）; and 12 had pancreatographic leak and elevated drain amylase （anastomotic leak）. Although drain volumes in the parenchymal leak group were significantly elevated at postoperative day （POD） 4, no difference was found at POD 7. Drain amylase level was not significantly different at POD 4. In contrast, at POD 7, the anastomotic-leak group had significantly elevated drain amylase level compared with normal and parenchymalleak groups （14158 ＋ 24083 IU/L vs 89 ＋ 139 IU/L and 1707 ＋ 1515 IU/L, respectively, P = 0.012）. CONCLUSION： For pancreatic remnant reconstruction after pancreaticoduodenectomy, a combination of pancreatogram and peripancreatic drain amylase levels can be used to distinguish between parenchymal and anastomotic leakage at pancreatic remnant reconstruction.
瞄准：在胰腺的残余的 duct-to-mucosa 重建把吻合与实质的漏区分开来。方法：我们考察了与 end-to-side duct-to-mucosa pancreatojejunostomy (PJ ) 在 5/2000 和 12/2005 之间执行的 68 pancreaticod-uodenectomies 的图表。pancreatography 的结果，以及仙子胰腺的排水管体积，和淀粉酶层次被分析。结果：68 pancreatojejunostomies， 48 没由 pancreatography 有漏缝并且有低排水管的淀粉酶(正常) ；八没让 pancreatographic 漏，但是提高了排水管淀粉酶(实质的漏缝) ；并且 12 让 pancreatographic 漏并且提高了排水管淀粉酶(吻合漏缝) 。尽管在实质的排水管体积漏，组显著地在手术后的白天(邮政部门) 被提高 4，没有差别在邮政部门 7 点被发现。排水管淀粉酶水平不在邮政部门 4 点是显著地不同的。在邮政部门 7 点，相反， anastomotic 漏缝组显著地与正常和 parenchymal 漏缝组相比提高了排水管淀粉酶水平(14158 +/- 24083 IU/L 对 89 +/- 139 IU/L 和 1707 +/- 1515 IU/L，分别地 P = 0.012 ) 。结论：为在 pancreaticoduodenectomy 以后的胰腺的残余重建，胰腺的排水管淀粉酶铺平的 pancreatogram 和仙子的联合能被用来在胰腺的残余重建在实质的和吻合漏之间区分。
