文章摘要

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

作者: 1邹方, 1陈梅福, 1李国光, 1李云峰, 1罗骁
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: 陈梅福 Email: chen_meifu@126.com
DOI: 10.3978/.10.3978/j.issn.1005-6947.2016.03.019

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。
关键词: 胰腺/ 损伤 胰十二指肠切除术 胰管空肠吻合术 胰腺瘘

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

Authors: 1ZOU Fang, 1CHEN Meifu, 1LI Guoguang, 1LI Yunfeng, 1LUO Xiao
1 Department of Hepatobiliary and Pancreatosplenic Surgery, Hunan Provincial People’s Hospital/the First Affiliated Hospital, Hunan Normal University, Changsha 410005, China

CorrespondingAuthor:CHEN Meifu Email: chen_meifu@126.com

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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