胰管直径与胰肠吻合方式的选择  

Selection of pancreaticoenterostomy on different pancreatic duct diameters

作　　者：罗燕君[1] 岑钧华[1] 李君[1] 

机构地区：[1]广州医科大学附属第一医院肝胆外科,广东广州510120

出　　处：《广州医科大学学报》2015年第2期38-41,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的:比较胰十二指肠切除术两种不同胰肠吻合方式的胰瘘发生率,探讨根据胰管的直径选择不同胰肠吻合方式的可行性。方法:回顾性分析2009年10月至2014年9月在广州医科大学附属第一医院行胰十二指肠切除术治疗的78例患者的临床资料,其中胰管直径≥0.3 cm者采用胰管空肠黏膜端侧吻合(A组)53例,胰管直径<0.3 cm者采用选择捆绑式胰肠吻合(B组)25例,比较两组患者术后胰瘘和其他并发症发生率。结果:总体胰瘘发生率为7.7%(6/78)。两组术后胰瘘、胆瘘、肠瘘、腹腔出血、腹腔感染、消化道出血发生率比较,差异均无统计学意义(P>0.05)。结论:在行胰十二指肠切除术时,可以根据胰管直径选择不同胰肠吻合方式。Objective： To compare the incidence of pancreatic fistula of two different pancreaticoenterostomies after pancreaticoduodenectomy and investigate the feasibility of selecting different pancreaticoenterostomies according to pancreatic duct diameters. Methods： The clinical data of 78 cases,who underwent pancreaticoduodenectomy in First Affiliated Hospital of Guangzhou Medical University between October2010 and September 2014,were retrospectively analyzed. Fifty-three cases with pancreatic duct diameter ≥0.3cm received end-to-side anastomosis of pancreaticojejunal mucosa（ group A）; and 25 with pancreatic duct diameter 〈0. 3 cm received binding pancreaticojejunostomy（ group B）. The incidence of postoperative pancreatic fistula and other complications were compared between the two groups. Results： The total incidence of pancreatic fistula was 7. 7%（ 6 /78）. There were no statistically significant differences in the incidences of pancreatic fistula, biliary fistula, intestinal fistula, intra-abdominal infection, intra-abdominal hemorrhage and gastrointestinal hemorrhage between the two groups（ P 〉0. 05）. Conclusion： Pancreaticoenterostomy can be selected based on different pancreatic duct diameters in pancreaticoduodenectomy.

关 键 词：胰十二指肠切除术 胰肠吻合方式 胰瘘 

分 类 号：R656.6[医药卫生—外科学]