胰腺外科专题研究(Monographic Study of Pancreatic Surgery)

贯穿式胰管空肠黏膜吻合在胰十二指肠切除术中的应用

Published at: 2015年第24卷第9期

王小明 1 , 沈正超 1 , 胡明华 1 , 韩猛 1 , 王冠男 1 , 方小三 1
1 皖南医学院第一附属医院 肝胆二科,安徽 芜湖 241001
通讯作者 小明 王 Email: wxm6901@aliyun.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.09.003
基金:
安徽省科学技术攻关基金资助项目 (1501041156)。

摘要

目的:探讨贯穿式胰管空肠黏膜吻合在胰十二指肠切除术(PD)中的应用价值。 方法:回顾性分析2013年1月—2015年3月61例行PD患者资料,其中34例行贯穿式胰管空肠黏膜吻合(观察组),27例行传统套入式胰肠吻合(传统组),比较两组各项临床指标。 结果:两组患者一般资料具有可比性。与传统组比较,观察组术中胰肠吻合时间明显减少[(14.9± 1.6)min vs.(22.6±2.6)min,P<0.05]、术后胰瘘发生率明显降低(11.76% vs. 37.03%,P<0.05);术后住院时间明显缩短[(16.5±4.9)d vs.(19.5±5.4)d,P<0.05];两组术中出血量、其他并发症发生率及术后1年生存率差异均无统计学意义(均P>0.05)。 结论:贯穿式胰管空肠黏膜吻合能有效降低PD后胰瘘的发生,是一种较为简单、有效的胰肠吻合方式,推荐其临床应用。


Application of pancreaticojejunostomy with duct-to-mucosa running-through suture following pancreaticoduodenectomy

Abstract

Objective: To assess the application value of pancreaticojejunostomy (PJ) with duct-to-mucosa running-through suture in pancreatieoduodenectomy (PD). Methods: The clinical data of 61 patients undergoing PD from January 2013 to March 2015 were retrospectively analyzed. Of the patients, 34 cases underwent PJ using the duct-to-mucosa through-and-through suture (observational group) and 27 cases underwent the conventional invagination PJ (conventional group). The clinical variables between the two groups were compared. Results: The general data were comparable between the two groups of patients. In observational group compared with conventional group, the time of intraoperative PJ was decreased [(14.9±1.6) min vs. (22.6± 2.6) min, P<0.05], the incidence of postoperative pancreatic fistula was reduced (11.76% vs. 37.03%, P<0.05), and the length of postoperative hospital stay was shortened [(16.5±4.9) d vs. (19.5±5.4) d, P<0.05]. There was no significant difference in intraoperative blood loss, incidence of other complications and postoperative 1-year survival between the two groups (all P>0.05). Conclusion: PJ with duct-to-mucosa running-through suture can reduce the incidence of postoperative pancreatic fistula, and it is a relatively simple and effective PJ method, and is recommended to be used in clinical practice.


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引用

引用本文: 小明 王, 正超 沈, 明华 胡, 猛 韩, 冠男 王, 小三 方. 贯穿式胰管空肠黏膜吻合在胰十二指肠切除术中的应用[J]. 中国普通外科杂志, 2015, 24(9): 1221-1226.
Cite this article as: WANG Xiaoming, SHEN Zhengchao, HU Minghua, HAN Meng, WANG Guannan, FANG Xiaosan . Application of pancreaticojejunostomy with duct-to-mucosa running-through suture following pancreaticoduodenectomy[J]. Chin J Gen Surg, 2015, 24(9): 1221-1226.