胆胰液分流预防胰十二指肠切除术后胰瘘的价值  

The value of bilipancreatic shunt to prevent pancreatic fistula after pancreatoduodenectomy

作　　者：曾庆东[1] 吕丽红[1] 李占元[2] 

机构地区：[1]山东大学齐鲁医院普外科,山东济南250012 [2]山东大学医学院手术学教研室,山东济南250012

出　　处：《中国现代普通外科进展》2002年第4期242-243,共2页Chinese Journal of Current Advances in General Surgery

摘　　要：目的 :探讨胆胰液分流预防胰十二指肠切除术后胰瘘的价值。方法 :对 91例胰十二指肠切除术患者胰、胆、胃消化道重建时分别采用改良Roux en Y吻合术、总胆管放置T型引流管和胰管内放置引流管 3种胆胰液分流术治疗 ,同时用未行胆胰液分流术 4 5例作对照。结果 :胰十二指肠切除术后行胆胰液分流术 91例的胰瘘发生率为 2 .2 % (2 91) ,未行胆胰液分流术 4 5例的胰瘘发生率为 15 .5 % (7 4 5 ) (P =0 .0 0 0 6 5 )。应用改良Roux en Y吻合术 6例 ,胰管内放置引流管 2 6例 ,无 1例出现胰瘘 ;总胆管放置T型引流管 5 9例 ,2例出现胰瘘。结论Objective:To explore the value of bilipancreatic shunt to prevent pancreatic fistula after pancreatoduodenectomy.Methods:The authers applied three kinds of bilipancreatic shunt:modified Roux en Y type anastomosis,T type drainage tube in common bile duct,drainage tube in pancreatic duct.Result of treatment was contrasted with non bilipancreatic shunt.Results:The incidence of pancreatic fistuta was 2.2% in this group with bilipancreatic shunt,and the contrast group 15.5%(P=0.00065).Modified Roux en Y anastomosis was used in 6 patients,drainage tube in pancreatic duct in 26 patients,no pancreatic fistula happened;T type drainage tube in common bile duct in 59 patients,2 pancreatic fistula happened.Conclusion:Bilipancreatic shunt is an important method to prevent pancreatic fistula after pancreatoduodenectomy.

关 键 词：胰头十二指肠切除术 胆胰液分流术 胰腺瘘 预防 术后 并发症 

分 类 号：R656.64[医药卫生—外科学] R657[医药卫生—临床医学]