胰十二指肠切除术中不同胰肠吻合方法的疗效比较  

Clinical effect comparison of different pancreaticojejunostomy in pancreaticoduodenectomy

作　　者：田恒宇[1] 

机构地区：[1]深圳市人民医院肝胆胰外科,518020

出　　处：《中国医师进修杂志》2013年第20期38-40,共3页Chinese Journal of Postgraduates of Medicine

摘　　要：【摘要】目的比较胰十二指肠切除术中不同胰肠吻合方法的临床疗效。方法回顾性对比分析92例行胰十二指肠切除术患者的临床资料，根据术中胰肠吻合方法分为捆绑式胰肠吻合组（A组，48例）和胰管对肠黏膜吻合组（B组，44例）。结果两组患者手术时间、术中出血量、术后住院时间和总并发症发生率比较差异无统计学意义（P〉0．05）；A组肛门排气时间长于B组[（101．73±6．47）min比（98．73±6．87）min]，胰瘘发生率低于B组[6．2％（3／48）比20．5％（9／44）]，消化障碍发生率高于B组[18．8％（9／48）比4．5％（2／44）]，差异均有统计学意义（P〈0．05）。结论两种胰肠吻合方法均能取得良好的临床疗效，捆绑式胰肠吻合可有效减少术后胰瘘的发生，胰管对肠黏膜吻合能有效减少消化障碍的发生，应根据术中情况选择最佳的吻合方式。Objective To compare the clinical effect of different pancreaticojejunostomy in panereaticoduodenectomy. Methods The data of 92 pancreaticoduodenectomy patients were retrospectively comparative analysis, the patients with bundled pancreaticojejunostomy was enrolled in group A （48 cases） and the patients with pancreatic duct on intestinal mucosa anastomosis was enrolled in group B （44 cases）. Results The results between the two groups in the operative time, blood loss, postoperative hospital stay and overall complication rate showed no significant difference （P 〉 0.05 ）. The anal exhaust time in group A was longer than that in group B [ （101.73 ± 6.47） min vs. （98.73 ± 6.87） mini,the rate of pancreatic juice leakage in group A was lower than that in group B [ 6.2% （3/48） vs. 20.5% （9/44） 1, but the rate of gastricism in group A was higher than that in group B [ 18.8%（9/48） vs. 4.5%（2/44） ] ,there were significant difference between the two groups （P 〈 0.05 ）. Conclusions The two pancreaticojejunostomy methods can achieve good clinical efficacy. Bundled panereaticojejunostomy can be effective in reducing the occurrence of simple pancreatic juice leakage. Pancreatic duct on intestinal mueosa anastomosis can effectively reduce the occurrence of gastricism, should base on intraoperative decision to choose the best fit manner.

关 键 词：胰十二指肠切除术 治疗结果 胰肠吻合术 

分 类 号：R735[医药卫生—肿瘤]