摘要
胰十二指肠切除术消化道重建的方法一直被认为与患者术后并发症、死亡率及生活质量密切相关.半个多世纪以来,各国学者围绕消化道重建提出了众多的手术改进和新方法.但长期以来,对这些术式的效果评价一直处于矛盾和争议中.近年,多个大样本的前瞻性临床随机研究结果见著报告,不少学者对这些问题重新进行了科学的荟萃分析,使我们对长期有争议的一些问题首次能有个正确认识.本文综述最新研究成果,对胰十二指肠切除消化道重建的主要术式,诸如胰肠吻合和胰胃吻合、胰肠Roux-en-Y式吻合与Child吻合、保留幽门胰十二指肠切除术与传统Whipple术、胰管对肠黏膜吻合与胰肠套入法吻合等,进行了综合对比分析,对目前临床上这些常用术式的客观作用和效果作出了初步评价.
Gastrointestinal reconstruction has been considered to be closely related to postoperative morbidity, mortality and quality of life of the patients who undergo pancreatoduodenectomy （PD）. For more than half a century, the scholars all around the world have offered numerous operative modifications and new procedures to im- prove the alimentary reconstruction for PD, but the effect and appraisal of these methods have always been controversial. In recent years many large prospective randomized controlled trials have been reported and the questions above have been re-studied based on the meta-analysis, which enables us to have a correct understand- ing about these questions for the first time. This article summarized newest research findings, and carried out the synthesis contrast analysis of the main methods of digestive canal reconstruction for PD such as pancreaticojejunostomy （PJ） versus pancreaticogastrostomy （PG）, the child type or Roux-en-Y technique, pylorus-preserv- ing pancreatoduodenectomy （PPPD） and the classic Whipple procedure （WPD）, duct-to- mucosa anastomosis versus end-to-end invaginated PD, etc. The objective effects of these commonly clinically used procedures are discussed in this paper.
出处
《世界华人消化杂志》
CAS
北大核心
2009年第5期476-481,共6页
World Chinese Journal of Digestology
关键词
胰十二指肠切除术
消化道重建
胰头癌
壶腹部癌
Pancreatoduodenectomy
Gastrointesti-nal reconstruction
Pancreas head carcinoma
Car-cinoma of ampulla
