贯穿式胰管空肠黏膜吻合在胰十二指肠切除术中的应用
| 作者: |
1王小明,
1沈正超,
1胡明华,
1韩猛,
1王冠男,
1方小三
1 皖南医学院第一附属医院 肝胆二科，安徽 芜湖 241001 |
| 通讯: |
王小明
Email: wxm6901@aliyun.com |
| DOI: | 10.3978/.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。
关键词：
胰十二指肠切除术；胰管空肠吻合术；胰腺瘘
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
CorrespondingAuthor:WANG Xiaoming Email: wxm6901@aliyun.com
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.
Keywords：
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.