临床研究(Clinical Research)

双U 套入荷包捆绑式胰肠吻合术在IV、V 型胰腺外伤中的应用

Published at: 2016年第25卷第3期

邹方 1 , 陈梅福 1 , 李国光 1 , 李云峰 1 , 罗骁 1
1 湖南师范大学第一附属医院/ 湖南省人民医院 肝胆胰脾外科,湖南 长沙 410005
通讯作者 梅福 陈 Email: chen_meifu@126.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.03.019
基金:

摘要

目的:探讨双U 套入荷包捆绑式胰肠吻合术在胰腺外伤中的应用价值。方法:回顾性分析2011 年1 月—2015 年1 月收治的9 例IV、V 型胰腺外伤患者的临床资料。结果:胰腺外伤IV 型7 例,其中5 例行胰头断端缝闭(U 形交锁+ 连续缝扎),双U 套入荷包捆绑式胰体尾空肠Roux-en-Y 内引流术后治愈;2 例合并十二指肠碎裂伤行胰十二指肠切除术、双U 套入荷包捆绑式胰肠吻合术后治愈。V 型患者2 例,均行胰十二指肠切除术、双U 套入荷包捆绑式胰肠吻合术后治愈。全组患者术后均未出现胰瘘、吻合口出血等严重并发症。所有患者均获得随访,一般情况良好,均无糖尿病、腹泻、消化不良等胰腺功能减退情况发生,无死亡。结论:双U 套入荷包捆绑式胰肠吻合法在胰腺外伤手术中是可行的,能够有效的防止术后胰瘘的发生。


Application of double U-suture invaginated pancreaticojejunostomy with binding purse-string sutures in treatment of grade IV and V pancreatic injury

Abstract

Objective: To determine the application value of using double U-suture invaginated pancreaticojejunostomy (PJ) with binding purse-string sutures in the treatment of pancreatic injury. Methods: The clinical data of 9 patients with grade IV and V pancreatic injury admitted from January 2011 to January 2015 were retrospectively analyzed. Results: Of the 7 patients with grade IV injury, 5 cases were cured by closure of the stump of the head of the pancreas (U type lock-stitch and continuous sutures), and double U-suture invaginated Roux-en-Y pancreaticojejunal internal drainage and binding purse-string sutures, and 2 cases with duodenal rupture were cured by pancreaticoduodenectomy (PD) and double U-suture invaginated PJ with binding purse-string sutures. Two patients with grade V pancreatic injury were both cured by PD and double U-suture invaginated PJ with binding purse-string sutures. No severe complications such as postoperative pancreatic fistula or anastomotic bleeding occurred in any of the 9 patients. All the patients were fellowed- up, and there were no diabetes, diarrhea or other complications, and no deaths. Conclusion: Double U-suture invaginated PJ with binding purse-string sutures is feasible in surgery for pancreatic injury, and it could effectively prevent the occurrence of postoperative pancreatic fistula.


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引用

引用本文: 方 邹, 梅福 陈, 国光 李, 云峰 李, 骁 罗. 双U 套入荷包捆绑式胰肠吻合术在IV、V 型胰腺外伤中的应用[J]. 中国普通外科杂志, 2016, 25(3): 418-422.
Cite this article as: ZOU Fang, CHEN Meifu, LI Guoguang, LI Yunfeng, LUO Xiao . Application of double U-suture invaginated pancreaticojejunostomy with binding purse-string sutures in treatment of grade IV and V pancreatic injury[J]. Chin J Gen Surg, 2016, 25(3): 418-422.