去除空肠黏膜的胰肠套入式吻合对胰十二指肠切除术后预防胰漏发生的价值  

Telescopic technique associated with mucosectomy in pancreaticoduodenectomy

作　　者：李鹏[1] 薛万江[1] 毛勤生[1] 倪启超[1] 冯盈[1] 王志伟[1] 李厚祥[1] 

机构地区：[1]南通大学附属医院普外科,江苏南通市226001

出　　处：《中华医学杂志》2016年第6期435-437,共3页National Medical Journal of China

摘　　要：目的 探讨胰十二指肠切除术中采用去除空肠黏膜的胰肠端端荷包套入式吻合技术对预防胰漏发生的价值.方法 回顾性分析了2007年5月至2012年5月间在南通大学附属医院普外科应用去除空肠黏膜的胰肠端端荷包套入式吻合技术的39例胰十二指肠切除术患者的临床资料和手术方法.结果 39例患者均顺利完成手术,术后住院天数为9～26 d,平均17 d,仅2例（5.1％）发生轻度胰肠吻合口漏,经保守引流治疗后痊愈,未见胰外分泌功能不足.无出血、胆管炎及手术相关死亡.结论 胰十二指肠切除术采用空肠黏膜切除的胰肠端端荷包套入式吻合能降低胰漏发生率,是胰十二指肠切除术的一种有效改进,值得推广.Objective To explore the feasibility of the telescopic technique associated with mucosectomy in preventing pancreatic fistula after pancreaticoduodenectomy （PD）.Methods The data of 39 patients who received PD in the Affiliated Hospital of Nantong University was retrospecively analyzed.We developed a safe and simple method of pancreaticojejunostomy in 39 patients,in whom approximately 3 cm of jejunal mucosa was cut to improve the adhesion between the loop and pancreatic parenchyma after end-to-end invagination.Results This procedure was proved to be much more expeditious,and only 2 of 39 （5.1%） patients had pancreatic leakages,who were treated with drainage only.No hemorrhage or cholangitis was observed.No postoperative mortality was observ ed.Conclusion The telescopic technique associated with mucosectomy is an acceptable and safe surgery for pancreaticojejunal anastomosis.

关 键 词：胰腺肿瘤 胰十二指肠切除术 胰肠吻合术 胰漏 

分 类 号：R656[医药卫生—外科学]