摘要
目的探讨“悬吊式”胰管－空肠端侧连续缝合吻合对胰十二指肠切除术后胰瘘发生的影响，探讨其实用性、安全性、有效性。方法采用非随机临床对照研究，对165例施行胰十二指肠切除术的临床资料行对比分析，比较三种不同胰肠吻合方法对胰瘘及其他并发症发生率的影响。结果总胰瘘发生率13．9％。端端或端侧套入式胰肠吻合组（A组）、端侧黏膜－黏膜胰管空肠吻合组（B组）和悬吊式胰管－空肠端侧连续缝合吻合组（C组）的胰瘘发生率分别是23．1％（12／52）、18．8％（9／48）和3．1％（2／65）。C组在手术时间、术中出血及术后血浆管引流量上优于A、B两组（P〈0．05），A、B两组间差异无统计学意义（P〉0．05）。其他并发症三组间差异无统计学意义（P〉0．05）。结论悬吊式胰管一空肠端侧连续吻合术能显著降低胰十二指肠切除术后的胰瘘发生率。该术式安全、实用、便捷，值得推广。
Objective To evaluate the impact of pancreatic-duct hanging and continuous suturing maneuver in end-to-side pancreaticojejunostomy on the incidence of pancreatic fistula after pancre- aticoduodenectomy （PD）, and to study the feasibility, safety and efficacy. Method 165 patients who underwent pancreaticoduodenectomy were randomly selected and the incidences of pancreatic fistula for the different types of pancreaticojejunostomy were analyzed. Results The overall rate of pancreatic fistula was 13.9% （23/165）. The incidences of pancreatic fistula after pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis （3. 1%, 2/65, group C） was significantly lower than the traditional intussusception anastomosis （23.1%, 12/52, group A, P〈0.05） and the mucosa-mucosa anastomosis （18.8%, 9/48, group B）. There was no significant difference between the traditional intussusception anastomosis and the mucosa-mucosa anastomosis （P〉0.05）. In group C, the average operative time, intraoperative blood loss, and postoperative drainage was obviously superior to the A and B group （P〈0.05）. There was no significant difference between the A and B group （P〉0.05）. The other complications showed no significant differences among the three groups （P〉0.05）. Conclusion Pancreatic-duct hanging and continuous suturing maneuver in end-to-side anastomosis significantly reduced the rate of pancreatic fistula after pancreaticoduedenectomy. It was feasible, safe, convenient to use and should be popularized.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2012年第12期912-915,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胰十二指肠切除术
手术后并发症
Pancreaticoduodenectomy
Postoperative complications
