连续缝合法在套入式胰肠吻合中的应用  

Continuous suture in invaginated pancreaticoenterostomy

作　　者：刘双海[1] 周一夫[1] 汤晓东[1] 陈胜[1] 薛红娣[1] 周标[1] 

机构地区：[1]东南大学医学院附属江阴医院肝胆外科,江苏江阴214400

出　　处：《中华胰腺病杂志》2011年第3期167-169,共3页Chinese Journal of Pancreatology

摘　　要：目的探讨在胰十二指肠切除术中利用连续缝合法进行套入式胰肠吻合对预防胰瘘发生的作用。方法通过采用4-0可吸收线连续缝合法对22例胰十二指肠切除患者进行端侧套入式胰肠吻合，并以同期实施的12例端侧套人式间断缝合、23例胰管空肠黏膜吻合术进行比较。结果22例患者均顺利施行套入式连续胰肠吻合，平均时问约13min，术后1例出现胆漏，未发生胰肠吻合口漏，无手术死亡。患者平均住院15d。同期端侧套人式间断缝合时间平均20min，术后发生胰漏2例，腹腔感染1例，其中1例并发腹腔大出血死亡；端侧胰管空肠黏膜吻合时间平均18min，发生胰漏1例，上消化道出血1例。术后患者平均住院19d。结论连续套入式胰肠吻合适用于任何情况下的残余胰腺，且操作简便、省时、并发症少，是胰肠吻合技术的一种有效改进。Objective To investigate the preventive effect of postoperative pancreatic leakage by continuous invaginated pancreaticoenterostomy in pancraticoduodenectomy. Methods Twenty-two pancraticoduodenectomy procedures were performed by continuous invaginated pancreaticoenterostomy with 4-0 absorbable suture and the results were compared with those of 12 end-to-side invagination interrupted suture procedures and 23 pancreatic duct jejunum anastomosis procedures. Results All continuous invaginated pancreaticoenterostomy cases were performed successfully with the average time of 13 minutes, and one biliary leak occurred postoperatively; and there was no pancreatic anastomotic leak and no death. The mean hospital stay of the patients was 15 days. While the mean time of end-to-side invagination interrupted suture procedures was 20 minutes, one biliary leak and one abdominal infection occurred, and one patient died of abdominal bleeding. The mean time of pancreatic duct jejunum anastomosis procedures was 18 minutes, and one pancreatic leak and one upper gastrointestinal bleeding occurred. The mean postoperative hospital stay of these patients was 19 days. Conclusions Continuous invaginated pancreaticoenterostomy is applicable to any situation in the residual pancreas, and has the advantages of easy to operate, time saving and less comulications, thus it is an effective improvement of Dancreaticoenterostomy.

关 键 词：吻合术 外科 胰十二指肠切除术 缝合技术 胰腺瘘 

分 类 号：R656[医药卫生—外科学]