贯穿式胰管空肠黏膜吻合在胰十二指肠切除术中的应用  

Application of pancreaticojejunostomy with duct-to-mucosa running-through suture following pancreaticoduodenectomy

作　　者：王小明[1] 沈正超[1] 胡明华[1] 韩猛[1] 王冠男[1] 方小三[1] 

机构地区：[1]皖南医学院第一附属医院肝胆二科,安徽芜湖241001

出　　处：《中国普通外科杂志》2015年第9期1221-1226,共6页China Journal of General Surgery

基　　金：安徽省科学技术攻关基金资助项目(1501041156)

摘　　要：目的:探讨贯穿式胰管空肠黏膜吻合在胰十二指肠切除术(PD)中的应用价值。方法:回顾性分析2013年1月—2015年3月61例行PD患者资料,其中34例行贯穿式胰管空肠黏膜吻合(观察组),27例行传统套入式胰肠吻合(传统组),比较两组各项临床指标。结果:两组患者一般资料具有可比性。与传统组比较,观察组术中胰肠吻合时间明显减少[(14.9±1.6)min vs.(22.6±2.6)min,P<0.05]、术后胰瘘发生率明显降低(11.76%vs.37.03%,P<0.05);术后住院时间明显缩短[(16.5±4.9)d vs.(19.5±5.4)d,P<0.05];两组术中出血量、其他并发症发生率及术后1年生存率差异均无统计学意义(均P>0.05)。结论:贯穿式胰管空肠黏膜吻合能有效降低PD后胰瘘的发生,是一种较为简单、有效的胰肠吻合方式,推荐其临床应用。Objective： To assess the application value of pancreaticojejunostomy （PJ） with duct-to-mucosa running-through suture in pancreatieoduodenectomy （PD）. Methods： The clinical data of 61 patients undergoing PD from January 2013 to March 2015 were retrospectively analyzed. Of the patients, 34 cases underwent PJ using the duct-to-mucosa through-and-through suture （observational group） and 27 cases underwent the conventional invagination PJ （conventional group）. The clinical variables between the two groups were compared. Results： The general data were comparable between the two groups of patients. In observational group compared with conventional group, the time of intraoperative PJ was decreased [（14.9±1.6） min vs. （22.6± 2.6） min, P〈0.05], the incidence of postoperative pancreatic fistula was reduced （11.76% vs. 37.03%, P〈0.05）, and the length of postoperative hospital stay was shortened [（16.5±4.9） d vs. （19.5±5.4） d, P〈0.05]. There was no significant difference in intraoperative blood loss, incidence of other complications and postoperative 1-year survival between the two groups （all P〉0.05）. Conclusion： PJ with duct-to-mucosa running-through suture can reduce the incidence of postoperative pancreatic fistula, and it is a relatively simple and effective PJ method, and is recommended to be used in clinical practice.

关 键 词：胰十二指肠切除术 胰管空肠吻合术 胰腺瘘 

分 类 号：R657.5[医药卫生—外科学]