肝圆韧带包绕胃十二指肠动脉残端技术对胰头十二指肠切除术后腹腔大出血的预防效果  

Efficacy of wrapping the stump of gastroduodenal artery with ligamentum teres hepatis on preventing massive abdominal hemorrhage after pancreaticoduodenectomy

作　　者：徐进[1] 许维雪[1] 刘宗剑[1] 梁含理 梁杰佳 张伟明[1] 王海南[1] 

机构地区：[1]中国医科大学附属盛京医院胰腺甲状腺外科,沈阳市110004

出　　处：《广西医学》2015年第12期1757-1759,共3页Guangxi Medical Journal

摘　　要：目的探讨肝圆韧带包绕胃十二指肠动脉残端技术在预防胰头十二指肠切除术后腹腔大出血中的临床效果。方法行胰头十二指肠切除术的患者119例,采用随机数字表法分为包绕组60例和非包绕组59例,非包绕组为常规双重结扎胃十二指肠动脉,包绕组为常规结扎动脉后,游离肝圆韧带包绕胃十二指肠动脉残端。比较术后胰瘘、腹腔大出血等并发症的发生情况。结果包绕组的术后住院天数、费用均少于非包绕组(P<0.05)。两组术后胰瘘的发生率比较,差异无统计学意义(P>0.05)。包绕组术后未出现腹腔大出血,而非包绕组出现4例发生腹腔大出血(6.78%),两组比较,差异有统计学意义(P<0.05)。结论对于预防胰头十二指肠切除术后腹腔大出血,肝圆韧带包绕胃十二指肠动脉残端可能是一种比较简单可靠的方法。Objective To explore the clinical efficacy of wrapping the stump of gastroduodenal artery （GDA） with ligamentum teres hepatis on preventing massive abdominal hemorrhage after pancreaticoduodenectomy. Methods A total of 119 patients tmdergoing pancreaticeduodenectomy were divided into wrapping group（ n =60 ） and non-wrapping group（n = 59 ） by random number table. Routine double ligation of GDA was conducted in the non-wrapping group,while in the wrapping group,the stump of GDA was wrapped with dissociated ligamentum teres hepatis after routine ligation of GDA. The incidences of postoperative complications including pancreatic fistula and massive abdominal hemorrhage were compared between two groups. Results The postoperative hospital stay and cost in the wrapping group were less than those in the non-wrapping group（ P 〈0. 05）. There was no significant difference in the incidence of postoperative pancreatic fistula between two groups （P 〉0. 05）. No massive abdominal hemorrhage occurred in the wrapping group ,but 4 cases（6.78% ） of massive abdominal hemorrhage in the non-wrapping group,and there was significant difference between two groups（P 〈 0.05 ）. Conclusion Wrapping the stump of GDA with ligamentum teres hepatis is a simple and reliable approach for preventing massive abdominal hemorrhage after pancreaticoduodenectomy.

关 键 词：胰头十二指肠切除术 腹腔大出血 术后 肝圆韧带 胃十二指肠动脉 残端 预防 

分 类 号：R656.64[医药卫生—外科学]