胰腺远端切除术后残端不同处理方法对术后胰瘘的影响  

Influence of Closure Techniques for the Pancreatic Stump on Pancreatic Fistula after Distal Pancreatectomy

作　　者：卢有胜[1,2] 王太洪[1,2] 张弘炜[1,2] 

机构地区：[1]南京医科大学附属肿瘤医院 [2]江苏省肿瘤医院,南京210009

出　　处：《中国现代手术学杂志》2013年第5期334-336,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨胰腺远端切除术中,胰腺残端不同处理方法与术后胰瘘的关系。方法回顾性分析我院2009年3月至2012年12月期间,行胰腺远端切除术的患者临床资料46例,其中胰腺残端行连续锁边缝合10例(A组);残端行主胰管结扎+连续鱼嘴状缝合16例(B组);残端断面局部行"8"字缝合+连续鱼嘴状缝合20例(C组)。比较上述3种方式对术后并发胰瘘的影响并行统计学分析。结果术后发生胰瘘病例数,A组6例(60%),B组2例(12.5%),C组3例(15%)。其中,A组与B组、A组与C组比较有统计学差异(P<0.05);B组和C组比较无统计学差异(P>0.05)。结论胰腺远端切除术中,胰腺残端行主胰管结扎+连续鱼嘴状缝合,或者行残端断面局部"8"字缝合+鱼嘴状连续缝合,是防止术后胰瘘安全有效的方法。Objective To study the influence of closure techniques for the pancreatic stump on pancreat- ic fistula（PF） after distal pancreatectomy. Methods The data of 46 patients who had undergone distal pan- createctomy between March 2009 and December 2012 were reviewed retrospectively. The incidences of PF a- mong patients with continuous suture catcher with 4-0 prolene（ Group A） and patients with continuous fish- mouth- like suture with duct ligation（Group B） or ＂8＂ suture（Group C） were compared. Results The inci- dence of PF was 60% （6/10） in Group A,12.5% （2/16） in Group B and 15% （3/20） in Group C. There was a statistically significant difference between Group A and the other two groups. No significant difference was found between Group B and Group C. Conclusion Continuous fish-mouth-like suture with duct ligation or with ＂8＂ suture for the pancreatic stump near the pancreatic duct would reduce the fistula formation rate after distal pancreatectomy.

关 键 词：胰腺切除术 胰腺瘘 胰腺管 缝合技术 

分 类 号：R657.5[医药卫生—外科学]