摘要
目的评价不同胰肠吻合方式在胰十二指肠切除术中的临床疗效,探讨不同胰肠吻合方式的适用性。方法回顾性分析2012年1月至2014年8月收治的117例行胰十二指肠切除术患者临床资料,按吻合方式不同分为胰管空肠黏膜吻合(A组,61例)和捆绑式胰肠吻合(B组,56例),比较两种不同胰肠吻合方式术后胰漏及相关并发症的发生率。结果胰肠黏膜吻合组胰腺残端直径明显大于捆绑式胰肠吻合组(t=7.441,P<0.05),捆绑式胰肠吻合组胰肠吻合时间明显小于胰肠黏膜吻合组(t=3.085,P<0.05)。两组患者术后胰漏、腹腔出血、腹腔感染、胃潴留、肺部感染、平均住院时间及费用,差异无统计学意义(x2=0.257,0.308,0.737,0.896,1.096;t=1.211,1.477;P>0.05)。结论胰管空肠黏膜吻合法和捆绑式胰肠吻合法是胰十二指肠切除术两种主要吻合方法,都能有效降低胰漏的发生率,应根据术中探查结果,合理灵活选择不同吻合方式。
Objective To explore suitability and evaluate the panereaticojejunostomy procedures in pancreaticoduodenectomy（PD）. Methods The clinical data of 117 cases who received pancreaticoduodenetomy from Jan. 2012 to Aug. 2014 were retrospectively analyzed. Duct-to-mucosa pancreaticojejunostomy（DMPJ）was applied to 61 cases（Group A） and binding pancreaticojejunostomy was applied to 56 cases（Group B）. The incidence of postoperative pancreatic fistula and postoperative complications were compared between two groups. Results The diameter of the pancreatic stump in the duct-to-mucosa pancreaticojejunostomy（DMPJ）group was sign ificantly larger t han that in the bi nding gro up（t=7.44 1, P〈0.05）; the time of the pancreaticojejunostomy in the binding group was significantly shorter than that in the duct-to-mucosa pancreaticojejunostomy（DMPJ） group（t=3.085, P〈0.05）. There were no significant differences in the incidences of pancreatic fistula, peritoneal bleeding, abdominal infection, digestive dysfunction rate and lung infection,The average medical expense and hospitalization duration between the two groups were（x^2=0.257, 0.308, 0.737,0.896, 1.096, t=1.211, 1.477, P〉0.05）. Conclusion Both the duct-to-mucosa pancreaticojejunostomy and the binding pancreaticojejunostomy are two important methods in PD, both of them can effectively reduce the incidence of pancreatic fistula and a reasonable choice between the two reconstructive methods in PD should be based on the intraoperative search expedition.
出处
《肝胆胰外科杂志》
CAS
2015年第2期100-103,共4页
Journal of Hepatopancreatobiliary Surgery
关键词
胰十二指肠切除术
胰肠吻合
胰漏
术后并发症
pancreaticoduodenectomy
pancreaticojejunostomy anastomosis
pancreatic fistula
postoperative complications
