荷包套入式胰空肠双重吻合术在胰十二指肠切除术中的应用  

Application of Purse-String Invaginated Double-Layer Anastomosis of Pancreaticojejunal in Pancreaticoduodenectomy

作　　者：王志远[1] 刘鹏[1] 袁伟升[1] 张华[1] 刁同进[1] 陈建锋[1] 宫林[1] 

机构地区：[1]中国人民解放军第401医院肝胆外科,山东青岛266071

出　　处：《中国普外基础与临床杂志》2008年第12期920-922,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的介绍一种胰肠吻合术式在胰十二指肠切除术中的应用。方法总结1985年12月至2007年12月期间我院211例荷包套入式胰空肠双重吻合术的临床应用和研究结果。首先,主胰管内置导管并加以固定,并使其粗细相互匹配,距胰腺断端2～3cm用7号丝线结扎胰腺,迫使胰液不从胰腺断端流出;然后再行一层胰腺断端空肠环行吻合和胰腺空肠荷包套入式吻合,即双重吻合术,使胰腺与空肠更贴紧,便于愈合。结果211例患者无一例并发胰瘘,无围手术期死亡;发生切口裂开2例,胆瘘4例;肠系膜上动脉切断1例。结论采用荷包套入式胰空肠双重吻合术式,手术操作安全可靠,可避免胰瘘发生。Objective To evaluate the application of a surgical method in pancreaticoduodenectomy. Methods All the 211 cases of purse-string invaginated panereatieojejunostomy performed from Dec. 1985 to Dec. 2007 were reviewed. Firstly, an accordant plastic tube was put and fastened in main pancreatic duct, and pancreas was ligated at 2-3 cm apart from the pancreatic stump to let secretin flow far away. Furthermore, invaginated pancreaticojejunostomy was performed to get closer between pancreas and jejunum. Results Pancreatic fistula and perioperative death didn＇t occur among these 211 cases. The complications included 2 cases of incision dehiscence, 4 cases of biliary fistula and 1 case of scission of superior mesentric artery. Conclusion Purse-string invaginated double-layer anastomosis of pancreaticojejunal would be feasible for pancreaticoduodenectomy preventing pancreatic fistula.

关 键 词：胰十二指肠切除术 荷包套入 胰空肠吻合术 双重吻合 胰瘘 

分 类 号：R656[医药卫生—外科学]