摘要
目的探讨胰十二指肠切除术后胰肠吻合口出血与胰肠套入捆扎吻合后胰管内置管留置空肠长度的关系。方法2006年8月至2011年8月行胰十二指肠切除术63例，均采用Child消化道重建方式，胰肠吻合重建分为A、B、C三组。A组22例，胰肠吻合采用胰腺残端套入空肠捆扎法吻合，胰腺残端外内支撑管长度15cm；B组21例，吻合方法同A组，胰腺残端外内支撑管长度为5cm；C组20例，采用胰腺残端与空肠黏膜吻合，胰腺残端外内支撑管长度为5cm。结果A组2例（9．1％）发生胰肠吻合口出血，经非手术治疗均痊愈。B组8例（38．1％）发生胰肠吻合口出血，其中2例因出血病死，3例行二次手术止血治愈，3例经非手术治疗痊愈。C组无一例发生胰肠吻合口出血。A组和B组患者发生出血的时间均在术后15d左右，A、B两组胰肠吻合口出血发生率的差异具有统计学意义（X^2=9．428，P=0．009）。结论胰肠套入捆扎吻合术后发生胰肠吻合口出血与胰管内支撑管留置空肠的长度过短有关。
Objective To explore the relations between the post pancreatoduodenectomy pancreatic anastomotie hemorrhage and the length of pancreatic duct endoprosthesis placed in the jejunum. Methods From August 2006 to August 2011, 63 patients underwent pancreatieoduodenectomy with the adopted child method for digestive tract reconstruction, while pancreaticojejunostomy reconstruction was divided into A, B, C groups. There were 22 cases in A group, and patients underwent panereaticojejunostomy with anastomosis of the pancreatic stump into the jejunum strapping method, the length of pancreatic duct endoprosthesis placed in the jejunum was 15 cm; there were 21 cases in B group, and patients received the same operation as patients in group A, but the length of pancreatic duct endoprosthesis placed in the jejunum was 5 cm; there were 20 cases in C group, and patients received pancreatic stump and jejunal mucosa anastomosis, the length of pancreatic duct endoprosthesis placed in the jejunum was 5 cm. Results In group A, two cases （9.1%） of pancreatic anastomotic hemorrhage occurred, and patients were cured by conservative treatment. In group B, eight cases （38.1%） of pancreatic anastomotic hemorrhage occurred, and two cases died of gastrointestinal bleeding; 3 cases received surgical operation to stop bleeding, and 3 patients were cured by conservative treatment. There was no anastomotic hemorrhage occurred in group C. The bleeding times of group A and group B were about 15 days after surgery, the difference of incidence of anastomotic bleeding between the two groups was statistically significant （X^2 = 9. 428, P = 0. 009）. Conclusions Post pancreaticojejunostomy anastomotic hemorrhage isassociated with short length of pancreatic duct endoprosthesis placed in the jejunum.
出处
《中华胰腺病杂志》
CAS
2013年第1期9-12,共4页
Chinese Journal of Pancreatology
