摘要
目的分析胰管内径对胰十二指肠切除术后胰瘘发生率的影响。方法选取1995年1月至2008年12月期间在我院行胰十二指肠切除术的患者256例,根据胰肠吻合方式分为胰管空肠端侧黏膜吻合组(n=115)、胰管空肠端端黏膜吻合组(n=71)、胰管空肠端端套入组(n=43)和胰胃吻合组(n=27)。另外,将238例患者根据不同引流方式分为支撑内引流组(n=132)和支撑外引流组(n=106),比较各组胰瘘的发生率;将223例患者根据胰管内径大小分为≤0.2 cm组(n=54)、0.2～0.4 cm组(n=93)和≥0.4 cm组(n=76),比较不同胰管内径对胰瘘发生率的影响。结果本组胰瘘发生率为8.20%(21/256)。各吻合方式的胰瘘发生率为:胰管空肠端侧黏膜吻合组为7.83%(9/115),胰管空肠端端黏膜吻合组为7.04%(5/71),胰管空肠端端套入组为13.95%(6/43),胰胃吻合组为3.70%(1/27),4组间差异无统计学意义(χ2=2.763,P=0.430);胰管支撑内引流组和支撑外引流组的胰瘘发生率分别为9.10%(12/132)和8.49%(9/106),差异无统计学意义(χ2=0.126,P=0.722)。胰管内径≥0.4 cm者无胰瘘发生,胰管内径在0.2～0.4 cm与胰管内径≤0.2 cm的胰瘘发生率分别为15.05%(14/93)和11.11%(6/54),3组间差异有统计学意义(χ2=12.009,P=0.002)。不同胰管内径的胰瘘发生率与胰肠吻合方式无关(χ2=1.878,P=0.598)。结论胰肠吻合方式对胰瘘发生率无影响,胰管内径是影响胰瘘发生的重要因素。
Objective To analyze the effect of inner diameter of pancreatic duct following pancreaticoduodenectomy on pancreatic fistula. Methods From January 1995 to December 2008, 256 patients underwent pancreaticoduodenectomy were divided into four groups based on the types of pancreaticojejunostomy： end-to-side ＂mucosa- to-mucosa＂ anastomosis group （n= 115）, end-to-end ＂mucosa-to-mucosa＂ anastomosis group （n= 71）, end-to-end invaginated pancreaticojejunostomy group （n=43） and pancreaticogastrostomy group （n= 27）. Alternatively, 238 patients were divided into two groups according to drainage ways： stenting tube for internal drainage group （n = 132） and stenting tube for external drainage group （n= 106）. Furthermore, 233 cases were divided into three groups on the basis of inner diameter of pancreatic duct： ≤0.2 cm group （n=54）, 0.2-0. 4 cm group （n=93） and ≥0.4 cm group （n= 76）. Then, the incidence rate of pancreatic fistula of each group was compared. Results The incidence of pancreatic fistula was 8.20% （21/256）. The incidence of pancreatic fistula for different types of pancreaticojejunostomy was as follow： end-to-side ＂mucosa-to-mucosa＂ anastomosis group （7.83%, 9/115）, end- to-end ＂mucosa-to-mucosa＂ anastomosis group （7. 04% , 5/71）, end-to-end pancreaticogastrostomy invaginated group （13.95 % , 6/43） and pancreaticogastrostomy group （3.70 % , 1/27）, in which there wasn＇t significant difference in 4 groups （X2 =2. 763, P= 0. 430）. There was no significant difference of the incidence of pancreatic fistula between stenting tube for internal drainage group （9. 10%, 12/132） and stenting tube for external drainage group （8.49%, 9/106）, X2=0.126, P=0.722. The incidence of pancreatic fistula in ≥0.4 cm group, 0.2--0.4 cm group and ≤0.2 cm group was respectively 0, 15.05% （14/93） and 11.11% （6/54）, and the difference was significant （X2=12. 009, P=0. 002）. No correlation was found between the incidence of pancrea
出处
《中国普外基础与临床杂志》
CAS
2009年第8期609-612,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胰管内径
胰十二指肠切除术
并发症
胰瘘
Inner diameter of pancreatic duct
Pancreaticoduodenectomy
Complication
Pancreatic fistula
