胰腺断端捆扎术式在腹腔镜胰腺体尾部切除术中的临床应用  

Clinical application of bundle ligation of pancreatic stump after laparoscopic distal pancreatectomy

作　　者：熊伟 董科 古春 XIONG Wei;DONG Ke;GU Chun(Department of Hepatobiliary Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People′s Hospital, Chengdu 610072,China)

机构地区：[1]四川省医学科学院.四川省人民医院肝胆外科,四川成都610072

出　　处：《实用医院临床杂志》2022年第1期60-63,共4页Practical Journal of Clinical Medicine

基　　金：四川省科技厅科研课题(编号:2020YFS0436);四川省干保委科研课题(编号:2018-214)。

摘　　要：目的探讨腹腔镜胰腺体尾部切除术中胰腺断端捆扎术式的临床应用,讨论该术式在腹腔镜操作下的安全性、实用性和有效性。方法收集2018年1月至2020年12月在我院肝胆外科开展腹腔镜胰腺体尾部切除术(LDP)的60例患者手术资料,根据手术方法不同分为Ⅰ组(普通闭合组)和Ⅱ组(断端捆扎组)各30例,比较两种胰腺断端处置术式的术后胰瘘以及并发症发生情况。结果60例患者中胰瘘总发生率为16.7%(10/60),Ⅰ组和Ⅱ组胰瘘发生率各为26.7%(8/30)和6.7%(2/30),差异有统计学意义(P<0.05);Ⅱ组术中出血量、腹腔引流量低于I组(P<0.05);两组间其他并发症发生率比较,差异均无统计学意义(P>0.05)。结论胰腺断端捆扎术式可以有效减少LPD术后胰瘘的发生,在腹腔镜手术操作下安全实用。Objective To explore the clinical application of bundle ligation of pancreatic stump after laparoscopic distal pancreatectomy(LDP),and to discuss the safety,practicability,and effectiveness of this operation under laparoscopic operation.Methods Sixty patients who underwent LDP in our hospital from January 2018 to December 2020 were collected.According to different surgical methods,the patients were divided intoa group Ⅰ(routine close group)and agroup Ⅱ(bundle ligation of pancreatic stump group),30 in each group.Theincidence of postoperative pancreatic fistula and other complications were compared between the two groups.Results The overall morbidity rate of pancreatic fistula was 16.7%(10/60).The occurrence rate of pancreatic fistula in the group Ⅰ was 26.7%(8/30),which was higher than 6.7%(2/30)of the group Ⅱ(P<0.05).The intraoperative blood loss and the postoperative abdominaldrainage in the group Ⅱ werelower than those in the group Ⅰ(P<0.05).There was no significant difference in other complications between the two groups(P>0.05).Conclusion Bundle ligation of pancreatic stump could significantly reduce the occurrence rate of pancreatic fistula after LDP.It is safe and practicable.

关 键 词：腹腔镜胰体尾切除术 胰瘘 胰腺断端捆扎 三维重建 

分 类 号：R657.5[医药卫生—外科学]