双重连续锁边缝合胰胃吻合术的临床应用研究  

The clinical application of pancreaticogastrostomy with double binding continuous hemstitch sutures

作　　者：陈冬[1] 朱峰[1] 王敏[1] 田锐[1] 秦仁义[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胆胰外科,武汉430030

出　　处：《临床外科杂志》2013年第4期258-260,共3页Journal of Clinical Surgery

基　　金：基金项目：国家自然科学基金资助项目（81272659,81071775,81101621）,国家“十一五”支撑项目（2006BA102A13-402）

摘　　要：目的介绍一种新的胰胃吻合术——双重连续锁边缝合胰胃吻合术，探讨其临床应用价值。方法92例壶腹部肿瘤，均行胰十二指肠切除术，胰腺消化道吻合方式采用双重连续锁边缝合胰胃吻合术。结果92例软质胰腺顺利进行胰十二指肠切除术，术后均采用双重连续锁边缝合胰胃吻合术。胰胃吻合中位时间为12min（8—24min），无手术死亡；术后15例发生并发症，包括术后出血2例，胆漏2例，肺部感染1例，胃瘫5，腹腔感染3例，胰漏2例（1例A级1例B级）。结论双重连续锁边缝合胰胃吻合术对术后并发症高发的软质胰腺是一种安全、简单和可操作性强的新型胰胃吻合方式，也有望为腔镜下胰胃吻合提供新的选择。Objective To introduce a new technique of pancreaticogastrostomy with double bind- ing continuous hemstitch sutures and investigate its signification of clinical application. Methods A total of 92 patients with periampullary malignancy underwent pancreaticoduodenectomy（PD）. All the eases un- derwent pancreaticogastrostomy with double binding continuous hemstitch sutures. Results The double binding continuous hemstitch sutures were applied in the soft pancreas of all 92 patients after PD. The me- dian time for the anastomosis was 12 minutes（ range 8 -24 min）and the operative mortality was zero. Fif- teen patients （ 16.3 % ） had complications, including 2 cases of hemorrhage,2 cases of biliary fistula, 1 case of pulmonary infection,5 cases of delayed gastric emptying,3 cases of abdominal abscess and 2 cases of pancreatic leakage（ 1 case of type A and 1 case of type B）. Conclusion The double binding continuous hemstitch sutures is a simple, safe and operational reconstruction procedure for patients with a soft and fragile pancreas, who have a high operative morbidity before. It could hopefully become a new choice for laparoscopic pancreaticogastrostomy.

关 键 词：胰十二指肠切除术 胰胃吻合 连续锁边缝合 

分 类 号：R735.2[医药卫生—肿瘤]