摘要
选择合理的消化道重建方式是减少胰十二指肠切除术后并发症发生以及提高生活质量的关键。目前,各种研究报道的众多消化道重建方法均未脱离胰肠吻合和胰胃吻合两大基本方式。这两种基于不同消化道器官的重建方式在围手术期并发症发生率和病死率方面差异无统计学意义,但从已发表的文献可见,两种主要的吻合方式对胰腺远期内外分泌功能以及生活质量的影响仍处于矛盾和争议之中。相对而言,对可能获得长期生存或已经有胰腺内外分泌功能不全的病人,可考虑首选胰肠吻合;而对于难以行胰肠吻合的病人,可考虑胰胃吻合。总之,选择何种重建方式应综合考虑外科医生的经验、病人原发疾病类型和胰腺内外分泌功能状态等诸多因素做出决定。
To reduce the complications and improve the quality of life after pancreaticoduodenectomy, it is important to choose a reasonable way for digestive tract reconstruction. Many modifications of the reconstruction method have been proposed by clinical experts. However, pancreaticojejunostomy and pancreaticogastrostomy are two basic methods for pancreatic stump and digestive tract reconstruction. While no significant differences in the perioperative complications and mortality have been described between these two reconstruction methods. Basing on current published literature, there is ongoing debate on which method to choose for reconstruction in consideration of the effect for pancreatic endocrine and exocrine function and quality of life. Relatively speaking, for some patients who may achieve long-term survival or have insufficient pancreatic endocrine and exocrine function, the pancreaticojejunostomy should be the first choice. However, pancreaticogastrostomy may be the choice for patients with difficult pancreaticojejunostomy. In conclusion, we should make a decision for the choice in reconstruction method after pancreaticoduodenectomy in view of the experience of the surgeon, the type of primary disease, and pancreatic endocrine and exocrine function.
出处
《中国实用外科杂志》
CSCD
北大核心
2016年第8期839-843,共5页
Chinese Journal of Practical Surgery
关键词
胰十二指肠切除术
胰肠吻合
胰胃吻合
生活质量
pancreaticoduodenectomy
pancreaticojejunostomy
pancreaticogastrostomy
quality of life
