单全层胰管对空肠黏膜吻合在腹腔镜胰十二指肠切除术中的应用  

Application of single-layer with full thickness of duct-to-mucosa pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy

作　　者：杜成旭 李冬瑞[1] 赵伟红[1] 何伟 苏明浩 牙学强 王文斌[1] Du Chengxu;Li Dongrui;Zhao Weihong;He Wei;Su Minghao;Ya Xueqiang;Wang Wenbin(Department of Hepatobiliary Surgery,Second Hospital of Hebei Medical University,Shijiazhuang 050004,China)

机构地区：[1]河北医科大学第二医院肝胆胰腺外科,石家庄050004

出　　处：《中华胰腺病杂志》2023年第4期258-264,共7页Chinese Journal of Pancreatology

基　　金：河北省自然科学基金(H2022206284)。

摘　　要：目的探讨单全层胰管对空肠黏膜吻合在腹腔镜胰十二指肠切除术中应用的可行性和安全性。方法回顾性收集2020年1月到2022年1月间河北医科大学第二医院采用单全层胰管对空肠黏膜吻合方式行腹腔镜胰十二指肠切除的45例患者的临床资料,与同期行传统双层胰肠吻合的45例配对患者的临床资料进行比较、分析。结果90例患者均在腹腔镜下完成胰十二指肠切除术。单全层胰肠吻合患者手术时间为(285.6±92.4)min,中位胰肠吻合时间为20(15,35)min,均显著短于传统双层胰肠吻合患者的(317.0±85.5)min和46(30,58)min,差异均有统计学意义(P值均<0.05)。两组患者术中出血量、术后并发症发生率、住院时间差异均无统计学意义。结论单全层胰管对空肠黏膜吻合方式安全可靠,与传统吻合方式相比操作简便、用时短,适合在腹腔镜下应用推广。Objective To explore the clinical efficacy and safety of single-layer with full thickness of duct-to-mucosa pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.Methods The clinical data of 45 patients who underwent laparoscopic pancreaticoduodenectomy with the procedures of single-layer with full thickness in Second Hospital of Hebei Medical University from Jan 2020 to Jan 2022 were retrospectively collected and compared with 45 matched patients with traditional two-layer pancreaticojejunostomy.Results The laparoscopic pancreaticoduodenectomy procedures were successfully performed in all the 90 cases.The mean operation time(285.6±92.4 minutes)and the media pancreaticojejunostomy time 20(15,35)minutes)of the single-layer with full thickness pancreaticojejunostomy group were shorter than those of the two-layer pancreaticojejunostomy group[the mean operation time:317.0±85.5 minutes,the media pancreaticojejunostomy time:46(30,58)minutes]with significantly statistical differences(all P value<0.05).There were no significantly statistical differences on intraoperative blood loss,the postoperative complications or hospital stay between the two groups.Conclusions Compared with traditional pancreaticojejunostomy,the single-layer with full thickness of duct-to-mucosa pancreaticojejunostomy is simple and safe,which has the advantage of easy manipulation and less time-consuming and can be recommended for laparoscopic procedures.

关 键 词：腹腔镜 胰十二指肠切除术 胰管空肠吻合术 胰腺瘘 

分 类 号：R656[医药卫生—外科学]