空肠浆肌鞘套入双捆绑预防胰肠吻合术后胰瘘的效果观察  

Application study of double binding-pancreaticojejunostomy in pancreatoduodenectomy

作　　者：许长起 边兰敏 张建雷 

机构地区：[1]山东省聊城市光明医院肿瘤中心普外科,山东聊城252000

出　　处：《中国现代普通外科进展》2009年第7期602-604,共3页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:通过与传统的胰十二指肠切除术进行比较,探讨空肠浆肌鞘套入双捆绑胰肠吻合对预防胰十二指肠切除术后胰瘘的效果。方法:行胰十二指肠切除患者40例,其中行空肠浆肌鞘套入双捆绑胰肠吻合的患者28例作为观察组,传统胰十二指肠切除术后套入式胰肠吻合的12例作为对照组。对2组的手术时间、术中出血量、术后胰瘘、术后并发症和住院时间以及住院费用等方面进行对比研究。结果:观察组术后胰瘘的发生率明显低于对照组(0vs2/12,P<0.05),2组在手术中出血量及手术后并发症发生率差异无统计学意义(P>0.05),但手术时间、术后住院时间短于对照组(P<0.05)。结论:相对于传统的胰十二指肠切除术中套入式胰肠吻合重建方式,空肠浆肌鞘套入双捆绑胰肠吻合方式简化了胰肠吻合过程,固定更牢靠,操作更简单,有双重保险的效果,预防术后胰瘘效果明显。Objective： To evaluate the application of double binding-pancreaticojejunostomy in pancreaticoduodenectomy and compare with traditional pancreaticojejunostomy. Methods： From July 1998 to November 2008, 40 patients who had undergone pancreaticoduodenectomy in our hospital were retrospectively analyzed. Observation group were 28 patients who had undergone double binding-pancreaticojejunostomy and control group were 12 patients who hard unclergone tradition pancreaticoduodenectomy. The different of operation time, amount of bleeding, pancreatic leakage, complication after operation, time, and cost inpatient were measured and compared between two groups. Date was analyzed by SPSS 13, Results： The median anastomosis time in patients of control group was significantly longer than that in research group. Although the postoperative complications had no significant difference in these two groups, the incidence of pancreatic fistula and the length of stay had the significant difference （P〈0.05）. Conclusions： The course of pancreaticojejunostomy is simplified by the double binding pancreaticojejunostomy compared with traditional pancreaticoduodenectomy. Anastomosis fixs firmly and the postoperative management seems too much simpler than the conventional method.

关 键 词：胰十二指肠切除术 双捆绑胰肠吻合 胰腺瘘 

分 类 号：R657.5[医药卫生—外科学]