捆绑式胰肠吻合与传统胰肠吻合术后并发症的比较  

Feasibility and Safety of the “Binding Technique” in Performing Pancreaticojejunostomy

作　　者：徐琳[1] 吴志勇[1] 

机构地区：[1]上海第二医科大学附属仁济医院普外科,200127

出　　处：《外科理论与实践》2002年第2期155-157,共3页Journal of Surgery Concepts & Practice

摘　　要：目的：探讨捆绑式胰肠吻合术在防止胰漏、减少并发症方面的临床价值。方法：回顾性分析１９９８年１月～２００１年８月我院施行捆绑式胰肠吻合术（同时行半胃切除）（捆绑组）３２例，并与同期传统胰肠吻合法（对照组）５１例作对比。观察术后胰漏、胆漏、胃排空障碍、消化道出血等并发症的发生率。结果：胰漏、胆漏、胃排空障碍和消化道出血发生率在捆绑组中分别为０％、６．３％（２／３２）、３．１％（１／３２）和３．１％（１／３２），以对照组中分别为１５．７％（８／５１）、１７．６％（９／５１）、１５．７％（８／５１）和１１．８％（６／５１）。术后平均住院天数捆绑组（２６．０５ｄ）较对照组（３８．２４ｄ）显著缩短。结论：捆绑式胰肠吻合术有助于避免胰漏的发生，以及由此所致的各种其他并发症。同时，半胃切除有助于减少吻合口溃疡或应激溃疡出血的产生。Objective:To evaluate the feasibility and the safety of the ＂binding technique＂ in performing pancreaticojejunostomy(BPJ). Methods:Pancreaticojejunostomy by the ＂binding technique＂ with hemi-gastrectomy was performed in 32 patients from January 1998 to Augest 2001. Conventional pancreaticojejunostomy(TPJ) was performed in 51 patients during the same period. Complications concluding pancreatic leakage, biliary leakage, delayed gastric emptying syndrome, gastrointestinal bleeding were compared between the 2 groups.Results:The rate of pancreatic leakage, biliary leakage, delayed gastric empting syndrome and gastrointestinal bleeding in patients was 0% (0/32), 6.3%(2/32), 3.1%(1/32), and 3.1%(1/32) in the BPJ group, while it was 15.7%(8/51), 17.6%(9/51), 15.7%(8/51), and 11.8%(6/51) respectively in the TPJ group. The average hospital stay after the operation was 26.05 days in the BPJ group while it was 38.24 days in the TPJ group(38.24 days).Conclusions:Pancreaticojejunostomy by the ＂binding technique＂ caused fewer pancreatic leakage and other complications. Occurrence of postoperative stomal ulcer and stress ulcer could be notably reduced by hemi-gastrectomy is applied.

关 键 词：胰十二指肠切除术 捆绑式胰肠吻合术 胰漏 胆漏 胃排空障碍 消化同血 

分 类 号：R657.5[医药卫生—外科学]