胰胃及胰肠吻合在胰腺中段切除术中的应用  

Application of pancreaticogastrostomy and pancreaticojejunostomy in central pancreatectomy

作　　者：陈品中[1,2] 陈丹磊[1] 刘安安[1] 汤靓[1] 侍力刚[1] 邵成浩[1] 

机构地区：[1]第二军医大学长征医院普外-胰胆外科,上海200003 [2]江阴市中医院急诊科,无锡214400

出　　处：《第二军医大学学报》2016年第1期87-90,共4页Academic Journal of Second Military Medical University

摘　　要：目的探讨胰腺中段切除术中胰胃、胰肠两种吻合方式对患者术后疗效及近期并发症的影响。方法回顾性分析单中心2013年5月至2015年5月25例胰腺中段切除术患者的临床资料,按重建方式分为胰胃吻合组(n=14)和胰肠吻合组(n=11),胰管与胃或肠黏膜唇状开口均以磁感应线式缝合方法吻合,比较两组术后胰瘘发生率、住院时间等指标。结果两组患者基线资料具有可比性;术后胰瘘发生率、住院时间比较差异无统计学意义;所有患者均未发生吻合口出血。2例近端胰腺残端瘘给予充分引流,同时给予奥曲肽、肠外营养等保守治疗痊愈出院。结论胰腺中段切除术能较好地保持胰腺功能,胰胃与胰肠吻合术均是安全的。Objective To assess the effects of applying pancreaticogastrostomy and pancreaticojejunostomy in central pancreatectomy on postoperative outcome and short-term complications. Methods The clinical data of 25 patients who received central pancreatectomy from May 2013 to May 2015 were retrospectively analyzed. The reconstruction methods were pancreaticogastrostomy or pancreaticojejunostomy, and the pancreatic duct were anastomosed with stomach or intestinal mucosa lips openings by magnetic induction line suture. Then the postoperative pancreatic fistula and hospital stay were compared between the two groups. Results The baseline data of two groups were comparable, and there were no significant differences in postoperative pancreatic fistula rates or hospital stay between the two groups. The 25 patients did not have anastomotic bleeding. Two cases with proximal pancreatic stump fistula were observed and were cured by adequate drainage, octreotide acetate injection, parenteral nutrition and so on. Conclusion Central pancreateetomy can better maintain the pancreas function. pancreaticogastrostomy and pancreaticojejunostomy are both safe.

关 键 词：胰胃吻合术 胰肠吻合术 胰腺中段切除术 并发症 胰瘘 磁感应线 

分 类 号：R657.5[医药卫生—外科学]