摘要
目的探讨封闭式单层胰肠吻合技术在胰十二指肠切除术中的应用效果。方法回顾性分析我院2014年1月至2015年5月期间行胰十二指肠切除术的85例患者的临床资料,其中行封闭式单层胰肠吻合术28例,胰管空肠黏膜端侧吻合术27例,端端套入式胰肠吻合术30例。比较3组间的胰肠吻合时间、腹腔引流管拔管时间、术后住院时间、胰瘘发生率的差异。结果 1胰肠吻合时间(min)在封闭式单层胰肠吻合组明显少于胰管空肠黏膜端侧吻合组(12.51±2.96比25.65±3.35,P<0.05)和端端套入式胰肠吻合组(12.51±2.96比23.73±5.27,P<0.05)。2腹腔引流管拔管时间(d)在封闭式单层胰肠吻合组明显少于端端套入式胰肠吻合组(7.65±1.30比11.15±3.47,P<0.05),但与胰管空肠黏膜端侧吻合组间比较差异无统计学意义(7.65±1.30比8.36±2.29,P>0.05)。3术后住院时间(d)在3组间比较差异均无统计学意义(9.52±3.96比11.97±3.53比12.27±3.78,P>0.05)。4封闭式单层胰肠吻合组发生1例A级胰瘘,胰管空肠黏膜端侧吻合组发生A、B级胰瘘各1例,端端套入式胰肠吻合组发生A级胰瘘1例、B级胰瘘2例,胰瘘发生率在3组间比较差异无统计学意义(P>0.05)。结论从本组有限的数据初步得出,封闭式单层胰肠吻合技术是一种相对安全的胰肠吻合方式,其操作简单,手术时间较短。
Objective To investigate effect of sealing one-layer anastomosis in pancreaticojejunostomy in patients underwent pancreaticoduodenectomy. Methods The clinical data of 85 patients underwent pancreaticoduodenectomy in this hospital from January 2014 to May 2015 were collected. Of all the patients, 28 patients were underwent sealing onelayer anastomosis in pancreaticojejunostomy（sealing one-layer anastomosis group）, 27 patients were underwent ductto-mucosa pancreaticojejunostomy（duct-to-mucosa anastomosis group）, and 30 patients were underwent end-to-side invaginated pancreaticojejunostomy（end-to-side invagination group）. The anastomosis time, time to pull out drainage tube, postoperative hospital stay, and incidence rate of postoperative pancreatic fistula were compared among these three groups. Results（1） The anastomosis time（min） of the sealing one-layer anastomosis group was significantly shorter than that of the duct-to-mucosa anastomosis group or end-to-side invagination group（12.51±2.96 versus 25.65±3.35, P〈0.05; 12.51±2.96 versus 23.73±5.27, P〈0.05）.（2） The time to pull out drainage tube of the sealing one-layer anastomosis group was significantly shorter than that of the end-to-side invagination group（7.65±1.30 versus 11.15±3.47, P〈0.05）.（3） The postoperative hospital stay had no statistical significances among these three groups（P〉0.05）.（4） The incidence of pancreatic fistula was 3.57%（1/28）, 7.41%（2/27）, and 10.00%（3/30） among the sealing one-layer anastomosis group, duct-to-mucosa anastomosis group, and end-to-side invagination group respectively, which had no statistical differences among these three groups（P〉0.05）. Conclusion Sealing one-layer anastomosis in pancreaticojejunostomy might be a safe anastomosis, and it has advantages of simple operation and short operation time.
出处
《中国普外基础与临床杂志》
CAS
2016年第5期577-580,共4页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胰十二指肠切除术
胰瘘
吻合术
Pancreaticoduodenectomy
Pancreatic fistula
Anastomosis
