改良双荷包缝合法胰肠吻合方式在腹腔镜胰十二指肠切除术中的运用

Application of "modified double pocket suture" pancreatoenterostomy in laparoscopic pancreatoduodenectomy

目的探讨改良双荷包缝合法胰肠吻合方式在腹腔镜胰十二指肠切除术中的运用价值。方法回顾性分析2021年1月至2022年5月在吉林大学第一医院普外中心肝胆胰外二科接受腹腔镜胰十二指肠切除术的273例患者的临床资料,并根据胰肠吻合方式分为改良双荷包缝合法方式组与洪氏一针法胰管空肠吻合方式两组,分析比较两组的临床疗效。结果改良双荷包缝合法方式组纳入189例患者,男107例,女82例,年龄(59.6±10.2)岁。洪氏一针法胰管空肠吻合组纳入84例,男52例,女32例,年龄(60.8±9.3)岁。改良双荷包缝合法不仅术后胰瘘发生率较低[B级胰瘘6.88%(13/89)比8.33%(7/84),C级胰瘘1.58%(3/189)比2.38%(2/84)],而且吻合时间较短[(25.25±4.73)min比(25.76±6.71)min],但两者差异均无统计学意义(均P>0.05)。同时两者在术后胆漏、腹腔出血、延迟性胃排空障碍等并发症之间差异均无统计学意义(均P>0.05)。结论改良双荷包缝合法胰肠吻合方式在腹腔镜胰十二指肠切除术中的运用是安全可行的。

Objective The purpose of this study was to explore the value of the"improved double purse-string suture method"for pancreatojejunostomy in laparoscopic pancreaticoduodene-ctomy.Methods The clinical data of 273 patients who underwent laparoscopic pancreaticoduode-nectomy in the Department of Hepatobiliary and Pancreatic Surgery of the First Hospital of Jilin University from January 2021 to May 2022 were retrospectively analyzed.According to the method of pancreaticoenteric anastomosis,the patients were divided into two groups:the"improved double purse-string suture method"group and the"Hong′s one-stitch method"group.Results The"improved double purse-string suture method"for pancreaticoenteric anastomosis was performed in a total of 189 patients,including 107 males and 82 females,with a mean age of(59.6±10.2)years.The"Hong′s one-stitch method"group"was performed in a group of 84 patients,including 52 males and 32 females,with a mean age of(60.8±9.3)years.The results showed that the"improved double purse-string suture method"group had a lower incidence of postoperative pancreatic fistula(6.88%vs 8.33%for grade B fistula,and 1.58%vs 2.38%for grade C fistula)and a shorter anastomosis time[(25.25±4.73)min vs(25.76±6.71)min]than the"Hong′s one-stitch method"group.There was no statistically significant difference between the two groups in terms of postoperative biliary fistula,abdominal bleeding,delayed gastric emptying,and other complications(P>0.05).Conclusion The"improved double purse-string suture method"for pancreatojejunostomy is safe and feasible in laparoscopic pancreaticoduodenectomy.