力学原理在胰十二指肠切除术中的应用:“1管2针3缝”式胰肠吻合术(附视频)  

Application of mechanical principles in pancreaticoduodenectomy:"1-tube,2-needle,3-suture"pancreaticojejunostomy(with video)

作　　者：张津鸣 沙洪存 陈鸣宇[1] ZHANG Jinming;SHA Hongcun;CHEN Mingyu(Department of General Surgery,Sir Run-Run Shaw Hospital,Zhejiang University,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院普通外科,浙江杭州310016

出　　处：《中国普通外科杂志》2024年第9期1422-1429,共8页China Journal of General Surgery

基　　金：国家自然科学基金资助项目(82473007)。

摘　　要：胰肠吻合是胰腺重建手术中最具挑战性的步骤之一,其影响患者的预后。胰腺具有形态上窄下宽、组织脆弱、富含消化酶以及肠道持续蠕动等特点,这些因素易导致胰肠吻合口的松动和术后胰瘘的发生。通过力学建模分析及临床实践总结,笔者提出了一种基于力学原理的胰肠吻合方法。该方法概括为“1管2针3缝”,即1根胰管支撑管、2种和2根不同缝线以及3种不同的缝合方法。本文将详细介绍这一操作方法,并深入解析其技术原理。此外,对笔者中心病例进行回顾性分析总结发现,该方法可有效降低术后胰瘘的发生率。The pancreatojejunostomy is one of the most challenging steps in pancreatic reconstruction surgery,and its success directly impacts the patient's prognosis.The pancreas has characteristics such as being narrow at the top and wide at the bottom,fragile in texture,rich in digestive enzymes,and subject to constant intestinal peristalsis.These factors can easily lead to the loosening of the pancreatojejunostomy site and the occurrence of postoperative pancreatic fistula.Through mechanical modeling analysis and a summary of clinical practice,the authors propose a pancreatojejunostomy method based on mechanical principles.This method is summarized as"1-tube,2-needle,3-suture"method,which refers to one pancreatic duct stent tube,two types and two strands of different sutures,and three different suturing techniques.This article will provide a detailed introduction to this operative method and deeply analyze its technical principles.Additionally,a retrospective analysis of cases from the authors'center found that this method can effectively reduce the incidence of postoperative pancreatic fistula.

关 键 词：胰十二指肠切除术 胰管空肠吻合术 力学 胰腺瘘 

分 类 号：R657.5[医药卫生—外科学]