改良胰肠吻合术中“悬吊式”胰管-空肠端侧连续缝合吻合在胰十二指肠切除术中的应用

摘要

Objective:To Investigate the applied value of pancreatic-duct hanging and end-to-side continuous pancreaticojejunostomy in pancreaticoduodenectomy by comparing it with other pancreaticojejunostomy methods. Method:78 cases from January 2012 to May 2013 who had underwent the pancreaticoduodenectomy because of the malignant tumors had been collected. To retrospectively analyze the different types of pancreaticoduodenectomy and their clinical information and prognosis. The 78 patients were divided into three groups according to the pancreatic anastomosis operation.For group A(20 cases):pancreatic-duct hanging and end-to-side continuous pancreaticojejunostomy;Group B(42 cases):End-to-side“pancreatic duct to jejunum mucosa-to-mucosa”anastomosis;Group C(16 cases):the other anastomoses. Result:Incidence of postoperative pancreatic fistula was lower than that in group B,group A and group C,the difference was statistically significant(P=0.01),at the same time,the incidence of postoperative anastomotic bleeding was lower than that in group B and C,the difference was statistically significant(P=0.003). Conclusion:Pancreatic-duct hanging and end-to-side continuous pancreaticojejunostomy significant decrease the risk of complications after the pancreaticoduodenectomy and pancreatic-duct hanging and end-to-side continuous pancreaticojejunostomy is become more and more common.%目的：通过与其他吻合术式比较，探讨“悬吊式”胰管-空肠端侧，连续缝合吻合在胰十二指肠切除术中的应用价值。方法：回顾性分析2012年9月-2013年5月本院78例因恶性肿瘤进行胰十二指肠切除术患者的术式、相关临床信息与预后。将78例患者按胰肠吻合术式分为A组（20例）：吊式胰管-空肠端侧连续缝合吻合组；B组（42例）：胰管空肠端侧黏膜-黏膜吻合组；C组（16例）：其他胰肠吻合法三组，比较不同方式的胰肠吻合手术术后胰瘘等并发症发生情况。结果：A组术后胰瘘发生率明显低于B组及C组，差异有统计学意义（P=0.01），同时术后吻合口出血的发生率也明显低于B、C两组，差异有统计学意义（P=0.003）。结论：“悬吊式”胰管-空肠端侧连续缝合吻合术明显降低十二指肠切除术后并发症的发生，其在胰十二指肠切除术的应用也越来越受到推广。