三维可视化系统结合单线连续胰肠端侧吻合术用于胰十二指肠切除术临床研究  

Application research on“one thread”pancreaticojejunostomy procedures in pancreaticoduodenectomy under the guidance of three-dimensional visualization

作　　者：项楠[1] 方驰华[1] 伍天崇[1] 范应方[1] 杨文哲[1] 杨剑[1] 曾宁[1] 钟世镇[1] 

机构地区：[1]南方医科大学珠江医院肝胆外科,广东广州510282

出　　处：《中国实用外科杂志》2014年第3期245-248,共4页Chinese Journal of Practical Surgery

基　　金：国家高技术研究发展(863)计划(2006AA02Z346;2012AA021105);国家自然科学基金项目(81170458);广东省自然科学基金团队项目(6200171);广东省重大科技专项计划项目(2012A030400013);广东省中科院全面战略协作项目(2010A090100032);广东省科技计划项目(2011B031800088;2011B031800091);广东省医学科研基金(A2011376)

摘　　要：目的研究三维可视化系统结合单线连续胰肠端侧吻合术在胰十二指肠切除术中预防胰瘘的临床应用价值。方法回顾性分析2012年1月至2013年11月南方医科大学珠江医院收治的26例需要行胰十二指肠切除术病人资料,术前运用腹部医学图像三维可视化系统(MI-3DVS)进行个体化肝胆胰、腹腔血管三维重建和术前规划,测量胰管直径、钩突部前壁上下缘之距离,指导单线连续胰肠端侧吻合。结果胰管直径为(2.9±1.3)mm,钩突部前壁上下缘之距离为(3.8±0.4)cm,26例病人均顺利施行单线连续胰肠端侧吻合,吻合时间(15.4±1.2)min。术后发生A级胰肠吻合口瘘2例,无腹腔出血、胆瘘等并发症发生,无手术死亡病例。术后住院时间(13.8±1.4)d。结论在胰十二指肠切除术中,三维可视化指导下单线连续胰肠端侧吻合,操作简便、吻合确切、并发症少,是一种有效预防胰瘘的胰肠吻合方法。Application research on “one thread” pancreaticojejunostomy procedures in pancreaticoduodenectomy under the guidance of three-dimensional visualization XIANG Nan,FANG Chi-hua,WU Tian-chong,et al. Department of Hepatobiliary Surgery,Zhujiang Hospital,Southern Medical University,Guangzhou 510282,China Corresponding author：FANG Chi-hua,E-mail：[e-mail] Abstract Objective To study the value of application on “one thread” pancreaticojejunostomy procedures in pancreaticoduodenectomy to prevent pancreatic fistula under the guidance of three-dimensional（3D）visualization. Methods The clinical data of 26 cases of pancreaticoduodenectomy between January 2012 and November 2013 in Zhujiang Hospital of Southern Medical University were analyzed retrospectively. They were underwent “one thread” pancreaticojejunostomy procedures in pancreaticoduodenectomy based on the liver,biliary tract,pancreas 3D reconstruction and surgical planning by the medical image three dimensional visualization system （MI-3DVS）. Results The measurements of the pancreatic duct diameter and pancreatic stump diameter were （2.9±1.3） mm and （3.8±0.4） cm by the preoperative 3D analysis. There were successfully implemented the “one thread” pancreaticojejunostomy procedures in 26 cases of pancreaticoduodenectomy. The pancreaticojejunostomy procedures time was （15.4±1.2） min. There were 2 cases of A grade pancreaticoenterostomy fistula. No operative death happened and no complications such as abdominal bleeding and bile leakage occurred in all cases. The lengths of postoperative hospital stay were（13.8±1.4）days. Conclusion The “one thread” pancreaticojejunostomy procedures guided by three-dimensional visualization technology in pancreaticoduodenectomy has the characteristics of being more easily to operate,exactly in the anastomosis procedures and being fewer complications,which is an effective improvement way to prevent pancreatic fistula.

关 键 词：三维可视化系统 单线连续胰肠端侧吻合 胰肠吻合 胰瘘 

分 类 号：R6[医药卫生—外科学]