三种不同胰肠吻合方法的腹腔镜胰十二指肠切除术临床对比研究  

Clinical comparison of three different methods of laparoscopic pancreaticoduodenectomy

作　　者：李勇军[1] 杨能红 Li Yongjun;Yang Nenghong(Guizhou Mediecal Uniersity,Guiyang Guizhou Prorince 550001,China;Department of Hepatobiliary Surgery,Afiliated Hospital of Guizhou Medical Unirersity,Giuiyang Guithou Province 550001,China)

机构地区：[1]贵州医科大学,贵阳550001 [2]贵州医科大学附属医院肝胆外科,贵阳550001

出　　处：《中华普外科手术学杂志（电子版）》2022年第6期663-666,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：贵州省中医药、民族医药科学技术研究专项课题项目(QZYY-2021-089)。

摘　　要：目的:研究间断外翻式胰肠吻合、“Double R”胰管空肠吻合和传统胰管空肠黏膜吻合在腹腔镜胰十二指肠切除(LPD)术中的应用效果。方法:前瞻性选取2019年1月至2021年3月行腹腔镜胰十二指肠切除术的75例患者为研究对象,按照随机数字表法分为A、B、C三组,每组各25例,A组行间断外翻式胰肠吻合,B组行“Double R”胰管空肠吻合,C组行传统胰管空肠黏膜吻合。观察三组患者围手术期指标、术后并发症发生情况。采用SPSS 20.0软件完成数据统计分析,术后并发症等计数资料采用χ^(2)检验;围手术期指标等计量资料用(x±s)表示,多组间比较行单因素方差分析,组间两两比较采用LSD-t检验。P<0.05为差异具有统计学意义。结果:B组手术时间、胰肠吻合时间显著短于A组、C组(P<0.05);A组住院时间显著短于B组、C组(P<0.05);三组患者术后胰瘘、胃瘫、术后出血及腹腔感染比较,差异无统计学意义(P>0.05)。结论:LPD中行间断外翻式吻合法虽延长了手术时间和胰肠吻合时间,但在降低胰瘘发生率、缩短住院时间存在优势,值得在临床推广。Objective To investigate the effect of intermittent valvcd pancreaticojejunostomy,"Double R"pancreaticojejunostomy and traditional pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy(LPD).Methods A total of 75 patients who underwent laparoscopic pancreaticoduodenectomy from January 2019 to March 2021 were prospectively selected as the research objects and divided into three groups according to the random number table method,25 coses in each group.Group A received intermittent valgus pancreaticojejunostomy,group B received"Double R"panrreaticojejunostomv.and group C received traditional pancreaticojejunostomy.The perioperative indicators and postoperative complications of the three groups were observed.SPSS 20.0 software was used for statistical analysis,and χ^(2) test was used for postoperative complications and other counting data.Measurement data such as perioperative indicators were expressed as(x±s).One-uay A NOV A of variance was user for comparison between multiple groups,and ISO-1 test was used for pairwise comparison between groups.P<0.05 was considered statistically significant.Results The operation lime and pancreaticojejunostomy time in group R were signifieantly shorter than those in groups A and C(P<0.05).The length of hospital stay in group A was significantly shorter than that in groups B and C(P<0.05).There were no significant differences in postoperative pancreatic fistula,gastroparcsis,postoperative bleeding and abdominal infection among the three groups(P>0.05).Conclusion Although intermittent valvae anastomosis in I.PD prolongs the operation time and pancreaticojejunostomy lime,it has advantages in reducing the incidence of pancreatic fistula and shortening the length of hospital slay,which is worthy of clinical promotion.

关 键 词：胰十二指肠切除术 腹腔镜 胰管空肠吻合术 疗效比较研究 

分 类 号：R657.5[医药卫生—外科学]