缝合还是器械闭合:胰体尾切除术胰腺残端处理  

Manual suture or stapler closure: management of pancreatic stump during distal pancreatectomy

作　　者：曲畅 杨尹默[1] Qu Chang;Yang Yinmo(Department of General Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院普通外科,100034

出　　处：《中华外科杂志》2020年第7期494-498,共5页Chinese Journal of Surgery

基　　金：国家自然科学基金(81672353、81871954);首都特色临床应用研究专项课题(Z161100000516038)。

摘　　要：胰瘘是胰体尾切除术后最常见的并发症。随着国内外指南及共识性文献对胰瘘定义的标准化,胰瘘及其分级与患者临床转归的相关性更为密切。胰体尾切除术后胰瘘风险因素评估、预测模型建立、胰腺断端处理方式等为目前热点课题。随着腹腔镜及机器人手术在胰体尾切除术中的广泛开展,胰腺离断及残端处理方式的选择更加复杂多样,手工缝合还是器械闭合,仍无统一规范,应视胰腺离断部位的质地、厚度、是否合并炎症等个体化选择。Postoperative pancreatic fistula is the most common complication after distal pancreatectomy.With the update of the domestic and international guidelines or consensuses,the definition of pancreatic fistula has become more standardized.And the classification of pancreatic fistula is able to represent the severity of clinical outcomes more accurately.Currently,the determination of risk factors of pancreatic fistula after distal pancreatectomy,the establishment of prediction model,and the surgical closure mode of pancreatic stump still remain the major topics.With the rapid development of laparoscopic and robotic surgery in pancreatectomy,there are more and more selectionsin transection and managing the pancreatic stump after distal pancreatectomy for prevention of pancreatic fistula.However,there has not been a uniform fashion in terms of manual suture or stapler use to close the pancreatic stump.Herein the current status and development of pancreatic fistula after distal pancreatectomy are reviewed.The strategy of managing the pancreatic stump after distal pancreatectomy should be adopted individually according to the texture and thickness of pancreatic parenchyma.

关 键 词：胰腺肿瘤 胰腺切除术 胰瘘 器械闭合 手工缝合 

分 类 号：R735[医药卫生—肿瘤] R657[医药卫生—临床医学]