改良胰十二指肠切除术185例手术体会  

Individualized End-side Pancreaticojejunostomy for Pancreaticoduodenectomy

作　　者：刘毅[1] 焦猛[2] 郭森[1] 陈雨信[1] 徐克森[1] 寿楠海[1] 

机构地区：[1]山东大学齐鲁医院,山东济南250012 [2]泰山医学院附属医院,山东泰安250000

出　　处：《肿瘤学杂志》2015年第10期810-813,共4页Journal of Chinese Oncology

摘　　要：[目的]探讨胰十二指肠切除术中胰腺空肠端侧吻合技术。[方法]回顾性分析185例胰十二指肠切除术行胰腺空肠端侧吻合患者的临床资料,结合术后并发症及死亡率、住院时间等,探讨胰腺空肠端侧吻合技术。[结果]根据患者胰腺的情况如质地、厚度、胰管直径、胰管后壁胰腺组织的厚度、有无炎症,结合空肠的直径、空肠壁的厚度选择胰管空肠黏膜—黏膜吻合、端侧套入式吻合等不同的吻合方式。术中胰肠重新吻合9例。术后胰瘘11例、胆瘘4例、死亡4例。胰管空肠黏膜—黏膜吻合时间较长。[结论]根据胰腺和空肠的情况进行个体化的胰管空肠黏膜—黏膜吻合、端侧套入式吻合等不同的吻合是胰十二指肠切除术中胰腺空肠吻合的理想选择。[ Purpose ] To analyze the procedure of end-side pancreaticojejunostomy after pancreati- coduodeneetomy （PD）. [Methods] The clinical data of 185 patients who underwent PD were re- viewed retrospectively. [ Results] Individualized end-side pancreaticojejunostomy was performed according to the thickness of pancreas,the diameter of pancreas duct and the pancreatitis com- bined with the diameter of jejunum and the thickness of the jejunum wall. Re-ananstomosis of panereaticojejunostomy was performed on 9 patients during operation. Pancreas fistula was oc- curred on 11 patients ,bile fistula on 4 patients. Four patients died in pancreatic fistula and heart failure postoperation. [Conclusion] Individualized end-side pancreaticojejunostomy according to the local condition of the operation is optimal for panereaticoduodenectomy.

关 键 词：胰十二指肠切除术 胰瘘 吻合 

分 类 号：R615[医药卫生—外科学]