不同胰肠吻合方式对胰十二指肠切除术后并发症的影响  

Influence of different methods of pancreatico-duodenectomy on postoperative complications of patients with pancreaticoduodenectomy

作　　者：郭宏斌 刘超 

机构地区：[1]辽宁省辽阳市中心医院普外科,辽宁辽阳111000

出　　处：《实用临床医药杂志》2015年第19期36-38,共3页Journal of Clinical Medicine in Practice

基　　金：中国高校医学期刊临床专项资金(11523405)

摘　　要：目的探讨不同胰肠吻合方式对胰十二指肠切除(PD)术后并发症的影响。方法根据术中胰腺重建方式的不同,将126例行PD术的患者分为黏膜-黏膜吻合组57例(行胰腺空肠黏膜-黏膜吻合)和端端吻合组69例(行套入式胰肠端端吻合),对比2组手术结局及术后并发症的差异。结果黏膜-黏膜吻合组死亡率1.75%(1/57),端端吻合组死亡率2.90%(2/69),2组死亡率无显著差异(P>0.05)。黏膜-黏膜吻合组术后胰漏总发生率显著低于端端吻合组(P<0.05),2组其余并发症发生率差异无统计学意义(P>0.05)。结论 PD术中行胰腺空肠黏膜-黏膜吻合的术后胰漏发生率显著低于套入式胰肠端端吻合,可能更利于患者病情康复。Objective To explore the influence of different methods of pancreatico-duodenectomy on postoperative complications of patients with pancreaticoduodenectomy（ PD）. Methods According to the distinguishing pancreatic re-construction,126 patients underwent PD were divided into mucous-mucous anastomosis group（ 57 cases,treated with anastomosis of pancreatic and jejunum mucous） and end-end anastomosis group（ 69 cases,treated with slip-on anastomosis of pancreatic and intestinal end）. Postoperative outcomes and complications were compared between two groups. Results The mortality rate was 1. 75%（ 1 /57） in the mucous-mucous anastomosis group,which was lower than 2. 90%（ 2 /69） in the end-end anastomosis group（ P 0. 05）. The mucous-mucous anastomosis group was markedly lower than the end-end anastomosis group in the total rate of postoperative pancreatic leakage（ P 0. 05）,but there was no significant difference between two groups in the rate of other complications（ P 0. 05）. Conclusion Intra-operative application of anastomosis of pancreatic and jejunum mucous has a lower rate of postoperative pancreatic leakage than slip-on anastomosis of pancreatic and intestinal end in PD,so it is more beneficial for the patients＇ rehabilitation.

关 键 词：胰肠吻合术 胰腺重建 胰十二指肠切除术 胰漏 

分 类 号：R574.51[医药卫生—消化系统]