胰十二指肠切除术中胰管处理方法的选择

Selection of the Disposal Methods of the Pancreatic Tubes in Pancreato-Duodenectomy

通过９年来３６例胰十二指肠切除病例的回顾分析，体会到胰腺残端的不同病理变化，如充血水肿、粗大、肥厚、胰管口径大小、与肠系膜上静脉及脾静脉粘连等，应采用不同的处理方法。单一、固定模式的处理胰腺残端是不可靠的，可能是胰瘘发生的主要原因。采用目前常用的４种方法，灵活应用是较适宜的，但应尽可能采用空肠胰腺残端套入或空肠胰管吻合法。

Through retrospective analysis of pancreato-duodenectomy on 36 patients for nineyears,we have realized that we should take different methods to dispose the pancreas' stump,because the pancreas' stump has different pathologic changes, such as hyperemid, hydrops,thick,the size of pancreatic duct,the adhesion with superior mesenteric vein or splenic vein.The single or fixed model disposal of the pancreas' stump is unreliable and may be the immediate cause of the pancreatic fistula. At present,flexiblely taking the four kinds of commonways is more suitable.