单层连续胰肠端端吻合联合大网膜环形包裹在胰十二指肠切除术中的应用  

Application of monolayer continuous pancreaticojejuna end-to-end suture associated with greater omentum wrapping in pancreaticoduodenectomy

作　　者：王玉柱[1] 秦涛[1] 刘传江[1] 胡明星[1] 张宏伟[1] 

机构地区：[1]郑州大学人民医院(河南省人民医院)肝胆胰腺外科,450003

出　　处：《中华实验外科杂志》2014年第10期2298-2299,共2页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（30972928、31140078）

摘　　要：目的 探讨在胰十二指肠切除术（PD）中采用单层连续胰肠端端吻合联合大网膜环形包绕对预防胰瘘的作用.方法 本治疗组61例PD中,应用传统胰空肠套入式32例,单层连续胰肠端端吻合29例,分析两组胰肠吻合时间、胰瘘等情况.结果 患者均顺利完成手术,胰肠吻合时间传统法为（26.0±5.0）min,单层连续法为（12.8±1.3） min;胰瘘发生率传统法为12.50％,单层连续法为6.89％;传统法出现消化道出血2例,两组均无胆瘘及围手术期死亡病例,术后住院时间：传统法为（17.3±4.1）d,单层连续法为（15.6±3.8）d.结论 单层连续胰肠端端吻合联合大网膜环形包裹术,操作简单,吻合时间短,能降低胰瘘发生率.Objective To investigate the preventive effect of postoperative pancreatic leakage by monolayer continuous pancreaticojejuna end-to-end suture associated with greater omentum wrapping in pancreaticoduodenectomy.Methods The study included 61 patients who were subjected to a duodenopancreatectomy and pancreaticoenterostomy performed by traditional or the new anastomosis technique.The operating time of pancreaticojejunostomy and postoperative complications including pancreatic fistula were observed.Results In the traditional pancreaticoenterostomy and monolayer continuous pancreaticojejuna endto-end suture,the operating time was （26.0 ± 5.0） and （12.8 ± 1.3） min,the incidence of pancreatic fistula was 12.50% and 6.89%,and the average length of postoperative hospital stay was （17.3 ± 4.1） and （15.6 ± 3.8） days respectively.There were 2 cases of gastrointestinal bleeding in traditional group.Conclusion The results of this study show that monolayer continuous pancreaticojejuna end-to-end suture associated with greater omentum wrapping procedures has the advantages of being more easily to operate,short operative time,and effectively reducing the morbility of pancreatic fistula.

关 键 词：胰肠吻合术 单层连续缝合 胰十二指肠切除术 

分 类 号：R656[医药卫生—外科学]