胰十二指肠切除术中Prolene线一针连续缝合法胰肠吻合的应用  

Application of Prolene thread-needle continuous suture method in pancreaticojejunostomy pancreaticoduodenectomy

作　　者：李昌[1] 韩冰[1] 王仰亮 杨东运 蓝诺[2] Li Chang;Han Bing;Wang Yangliang;Yang Dongyun;Lan Nuo(Department of Hepatobiliary Surgery,Shanxian Central Hospital of Heze City,Heze 274300,China;Department of Anesthesiology,Shanxian Central Hospital of Heze City,Heze 274300,China)

机构地区：[1]菏泽市单县中心医院肝胆外一科,菏泽274300 [2]菏泽市单县中心医院麻醉科,菏泽274300

出　　处：《中国医师进修杂志》2022年第4期322-325,共4页Chinese Journal of Postgraduates of Medicine

基　　金：济宁医学院教师科研扶持项目(JYFC2018FKJ046)。

摘　　要：目的探讨胰十二指肠切除术中Prolene线一针连续缝合法胰肠吻合的应用价值。方法选取2017年1月至2020年12月菏泽市单县中心医院收治的80例术前诊断为壶腹周围肿瘤行胰十二指肠切除术患者的临床资料,按照胰肠吻合方式的不同分为A、B组,每组40例,A组采用胰管-黏膜吻合,B组采用Prolene线一针连续缝合。比较两组患者术前临床资料、手术相关指标和术后并发症发生情况。结果两组患者在性别构成、年龄、白蛋白水平、胰管直径、合并基础疾病、术前胆红素、入院症状、术前胆道引流、肿瘤部位方面比较差异无统计学意义(P>0.05)。B组患者手术时间、术中出血量、术后引流量、胰肠吻合时间、术后住院时间均低于A组[(353.64 ± 95.28) min比(395.38 ± 110.29) min、(330.19 ± 100.27) ml比(397.43 ± 105.97) ml、(330.57 ± 110.68) ml比(376.18 ± 94.73) ml、(20.74 ± 8.08) min比(31.06 ± 7.83) min、(18.72 ± 6.02) d比(23.79 ± 7.41) d],差异有统计学意义(P<0.05)。B组患者胰漏、胰瘘、腹腔感染、肺部感染、胆瘘、胃排空延迟发生率均低于A组[10.0%(4/40)比20.0%(8/40)、7.5%(3/40)比20.0%(8/40)、2.5%(1/40)比12.5% (5/40)、0比7.5%(3/40)、5.0%(2/40)比17.5%(7/40)、7.5%(3/40)比17.5%(7/40)],差异有统计学意义(P<0.05)。结论 Prolene线一针连续缝合法应用于胰十二指肠切除术胰肠吻合操作中,能有效缩短手术时间,吻合牢靠,可降低术后胰瘘并发症的发生风险。Objective To investigate the application value of Prolene thread-needle continuous suture method in pancreaticojejunostomy pancreaticoduodenectomy.Methods The clinical data of 80 patients with preoperative diagnosis of periampullary tumors undergoing pancreaticoduodenectomy who were admitted to Shanxian Central Hospital of Heze City from January 2017 to December 2020 were selected.According to the different methods of anastomosis,80 patients were divided into A group and B group,each group with 40 patients,the patients in A group were performed pancreatic duct-mucosal anastomosis and the patients in B group were performed Prolene thread-needle continuous suture.The preoperative clinical data,operation-related data,postoperative complications in two groups were compared.Results There were no statistically significant differences between the two groups in clinical data such as gender,age,albumin level,pancreatic duct diameter,combined underlying diseases,preoperative bilirubin,admission symptoms,preoperative biliary drainage and tumor location(P>0.05).The operation time,intraoperative blood loss,postoperative drainage,operation durationand postoperative hospital stay in B group were lower than those in A group:(353.64±95.28)min vs.(395.38±110.29)min,(330.19±100.27)ml vs.(397.43±105.97)ml,(330.57±110.68)ml vs.(376.18±94.73)ml,(20.74±8.08)min vs.(31.06±7.83)min,(18.72±6.02)d vs.(23.79±7.41)d,the differences were statistically significant(P<0.05).The incidence of complications such as pancreatic leakage,pancreatic fistula,abdominal infection,lung infection,biliary fistula and delayed gastric emptying in B group were lower than those in A group:10.0%(4/40)vs.20.0%(8/40),7.5%(3/40)vs.20.0%(8/40),2.5%(1/40)vs.12.5%(5/40),0 vs.7.5%(3/40),5.0%(2/40)vs.17.5%(7/40),7.5%(3/40)vs.17.5%(7/40),the differences were statistically significant(P<0.05).Conclusions Prolene thread-needle continuous suture method in pancreaticojejunostomy pancreaticoduodenectomy has the characteristics of simple operation,effective shortening

关 键 词：胰十二指肠切除术 外科吻合口 缝合技术 PROLENE线 胰瘘 

分 类 号：R735.0[医药卫生—肿瘤]