陈氏贯穿胰腺纵向“U”型缝合法在胰管细小的腹腔镜胰腺中段切除术中的应用  

The Application of Chen’s Penetrating Longitudinal "U" Pancreaticojejunostomy in Laparoscopic Middle Pancreatectomy for Patients without Pancreatic Duct Dilatation

作　　者：马嘉骏 谢敏[1] 李云峰[1] 王方明 田秉璋[1] MA Jia-jun;XIE Min;LI Yun-feng;WANG Fang-ming;TIAN Bing-zhang(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital),Changsha 410005,Hunan,China)

机构地区：[1]湖南师范大学附属第一医院(湖南省人民医院)肝胆外科,长沙410005

出　　处：《中国现代手术学杂志》2022年第6期419-423,共5页Chinese Journal of Modern Operative Surgery

基　　金：湖南省临床医疗技术创新导引项目(2020SK50916)。

摘　　要：目的 初步探讨陈氏贯穿胰腺纵向“U”型缝合法在胰管细小的腹腔镜胰腺中段切除术中的应用价值。方法 回顾性分析湖南师范大学附属第一医院(湖南省人民医院)肝胆外科2022年6月~10月收治3例胰管细小的胰颈部肿瘤患者,均采用陈氏贯穿胰腺纵向“U”型缝合法行胰肠吻合。结果 3例患者均行腹腔镜手术,胰腺近端用直线切割闭合器离断,胰腺远端用超声刀离断。术中见胰尾残端胰管开口细小,置入硬膜外导管做支撑管引流。游离远端胰腺约2 cm以备与空肠行Roux-en-Y吻合,4-0薇乔线缝合固定硬膜外导管,间断缝合胰腺断面,胰尾残端与空肠行陈氏贯穿胰腺纵向“U”型缝合。胰肠吻合口前、后方各留引流管1根。手术过程顺利,术后恢复良好,顺利出院。结论 陈氏贯穿胰腺纵向“U”型缝合法适用于胰腺质地柔软、胰管细小的患者,可应用于腹腔镜胰腺中段切除术中的胰肠吻合。Objective To explore the application value of Chen’s penetrating longitudinal "U" pancreaticojejunostomy in laparoscopic middle pancreatectomy for patients without pancreatic duct dilatation. MethodsThe clinical data of 3 patients with pancreatic neck tumors admitted to the Department of Hepatobiliary Surgery of the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People’s Hospital) from June to October 2022 were retrospectively analyzed. All patients were treated with laparoscopic Chen’s penetrating longitudinal "U" pancreaticojejunostomy after central pancreatectomy. Results Laparoscopic surgery was performed in all 3 patients. The healthy tissue in the head area of the pancreas was divided with the linear stapler. After reaching the healthy pancreas in the tail region, the tumorous segment was resected with an ultrasonic knife. The opening of the pancreatic duct at the stump of the tail was tiny, and an epidural catheter was placed as a support tube for drainage. Roux-en-Y anastomosis was performed for the distal-pancreaticojejunostomy. The epidural catheter was fixed with 4-0 Vicryl suture. The pancreatic section was intermittently sutured, and Chen’s penetrating longitudinal "U" pancreaticojejunostomy was used between the pancreatic tail stump and the jejunum. The operation process was smooth, the postoperative recovery was good, and the patients were discharged smoothly. Conclusion Chen’s penetrating longitudinal "U" pancreaticojejunostomy is suitable for patients with soft pancreas and small pancreatic duct, and can be used for pancreaticojejunostomy in laparoscopic central pancreatectomy.

关 键 词：陈氏吻合术 胰肠吻合 胰腺中段切除术 

分 类 号：R735.9[医药卫生—肿瘤]