陈氏胰肠吻合在腹腔镜胰十二指肠切除术中应用的疗效观察  

Observation of therapeutic effects of Chen’s pancreatojejunostomy in laparoscopic pancreaticoduodenectomy

作　　者：朱媛 余金 孙华朋[2] 李晓刚[2] 廖晓锋[2] ZHU Yuan;YU Jin;SUN Huapeng;LI Xiaogang;LIAO Xiaofeng(School of Medicine,Wuhan University of Science and Technology,Wuhan 430065,China;不详)

机构地区：[1]武汉科技大学医学部医学院,430065 [2]湖北文理学院附属襄阳市中心医院普外科

出　　处：《临床外科杂志》2025年第3期289-293,共5页Journal of Clinical Surgery

基　　金：湖北文理学院2024年研究生教育质量工程项目(YZ4202401)。

摘　　要：目的探讨陈氏胰肠吻合在腹腔镜胰十二指肠切除术中应用的效果。方法2019年1月~2024年12月行腹腔镜胰十二指肠切除术病人176例。依据术中胰肠吻合方式分为两组:采用陈氏胰肠吻合的病人为研究组(102例),采用胰管对空肠黏膜吻合的病人为对照组(74例)。比较两组病人的手术时间、胰肠吻合时间、术中出血量、术后并发症发生率、术后住院时间及术后30天死亡率等临床指标。结果176例病人均顺利完成腹腔镜胰十二指肠切除术。两组病人术中出血量、生化漏、腹腔出血、胃排空障碍、胆漏、腹部感染发生率和术后30天死亡率比较差异无统计学意义(P>0.05)。研究组胰肠吻合时间为(22.33±5.95)分钟,手术时间为(334.60±66.42)分钟,对照组分别为(30.70±5.50)分钟和(414.46±60.96)分钟,两组比较差异有统计学意义(P<0.05)。两组病人术后均未发生C级胰瘘,研究组术后B级胰瘘发生率(5.88%)低于对照组(16.22%),差异有统计学意义(P<0.05);研究组病人术后住院时间为(17.10±6.89)天,对照组为(20.88±8.40天),两组比较差异有统计学意义(P<0.05)。结论陈氏胰肠吻合操作简便且安全有效,能够缩短胰肠吻合时间,降低术后胰瘘发生率,减少病人术后住院时间。Objective To explore the clinical application effects of Chen’s pancreatojejunostomy in laparoscopic pancreaticoduodenectomy.Methods Clinical data of 176 patients who underwent laparoscopic pancreaticoduodenectomy in Xiangyang Central Hospital from January 2019 to December 2024 were retrospectively analyzed.According to the methods of intraoperative pancreatojejunostomy,the patients were divided into two groups,the research group(102 cases)using Chen’s pancreatojejunostomy,and the control group(74 cases)using duct-to-mucosa pancreatojejunostomy.The two groups were compared on clinical indicators,including operation time,pancreatojejunostomy time,intraoperative blood loss,incidence of postoperative complications,length of hospital stay,and 30-day postoperative mortality rate.Results All 176 patients successfully underwent laparoscopic pancreaticoduodenectomy.There were no statistically significant differences between the two groups in intraoperative blood loss,biochemical leakage,abdominal bleeding,upper gastrointestinal bleeding,delayed gastric emptying,bile leakage,abdominal infection,and 30-day postoperative mortality rate(P>0.05).The pancreatojejunostomy time[(22.33±5.95)min]and operation time[(334.60±66.42)min]in the study group were significantly shorter than those in the control group[(30.70±5.50)min]and[(414.46±60.96)min],with statistically significant differences(P<0.05).Two groups of patients did not develop grade C pancreatic fistula.The incidence of grade B pancreatic fistula in the study group(5.88%)was significantly lower compared to the control group(16.22%),and this difference was statistically significant(P<0.05).Additionally,The postoperative hospital stay of the study group patients[(17.10±6.89)days]was significantly shorter than in the control group[(20.88±8.40)days],with a statistically significant difference(P<0.05).Conclusion Chen’s pancreatojejunostomy is a feasible,safe,and effective procedure in laparoscopic pancreaticoduodenectomy,which can shorten the pancreatojejunostomy ti

关 键 词：陈氏胰肠吻合 腹腔镜胰十二指肠切除术 术后胰瘘 术后并发症 

分 类 号：R47[医药卫生—护理学]