胰管引流与非引流在预防胰十二指肠切除术后胰瘘发生的作用观察  

The Clinical Significance of Drained Versus Nondrained Pancreaticojejunostomy in Prevention of the Pancreatic Leakage after Pancreaticoduodenectomy

作　　者：孙汴生[1] 杨汉新[1] 王勇强[1] 马忠明[1] 宋念[1] 

机构地区：[1]成都市第一人民医院肝胆外科,成都610016

出　　处：《中国普外基础与临床杂志》2002年第2期118-120,共3页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的　探讨胰管引流与非引流在预防胰十二指肠切除术后胰瘘发生的作用。方法　我们回顾性地分析了76例胰十二指肠切除病例 ,手术范围包括远端半胃、胆总管、胰头、十二指肠整块切除 ;消化道重建采用胰空肠端侧吻合或胰管空肠粘膜端侧吻合 ,76例中 45例胰管内安置外引流 ,3 1例未安置胰管引流。结果　胰管外引流 45例中 ,1例(2 .2 % )发生胰瘘 ;而 3 1例未安置胰管外引流病例中 7例 (2 2 .6% )发生胰瘘 ,胰管外引流组术后胰瘘发生率明显低于胰管非引流组 (P<0 .0 5 )。结论　胰十二指肠切除胰肠吻合时胰管内安置外引流能降低术后胰瘘的发生率 。Objective To investigate the effect of drained versus nondrained pancreaticojejunostomy on prevention of the pancreatic leakage after pancreaticoduodenectomy. Methods Seventy six patients underwent the standard pancreaticoduodenectomy including resection of the distal stomach,common bile duct, the head of pancreas and the duodenum.Pancreatic enteric reconstruction was accomplished via either pancreaticojejunostomy by end to side anastomsis or pancreaticojejunostomy by duct to mucosa anastomsis.The stented external drainage of pancreatic duct was used in 45 of 76 patients. Results Pancreatic leakage was identified in 1 patient in the drained group consisting of 45 patients,in 7 patients in the nondrained group consisting of 31 patients, the incidence of pancreatic leakage in the drained group (2.2%) was significantly less than in the nondrained group (22.6%, P <0.05).Conclusion Comparing the incidences of pancreatic leakage from both groups,the authors believe that the stented external drainage of pancreatic duct can significantly reduce the incidence of pancreatic leakage after pancreaticoduodenectomy.

关 键 词：胰十二指肠切除 胰瘘 胰管引流 手术后 

分 类 号：R657.5[医药卫生—外科学] R656.64[医药卫生—临床医学]