胃与十二指肠升段吻合在胰十二指肠切除术中的应用

Application of the anastomies in rising section of stomach and duodenum in pancreatoduodenectomy

目的:探讨胰十二指肠切除术改良式的临床价值。方法:对改良胰十二指肠切除术24 例(A组)与经典胰十二指肠切除术24例(B组)的手术时间、术中出血量、术后营养和术后并发症等进行比较分析。结果: A、B 两组的手术时间分别为(192. 67±45 .32 )、( 228. 08±36. 80 ) min,t=3 .417,P= 0 .002;术中出血量分别为(365. 54±101 .57)、(488 .79±101 .00)mL,t=3. 796,P=0 .001;术后体质量增加分别为( 0. 78±1 .20 )、( 0 .29±1. 89 ) kg,t=1. 011,P=0. 323。A组术后无吻合口溃疡,无返流性胃炎;B组术后吻合口溃疡3 例,返流性胃炎8 例。结论:改良的胰十二指肠切除术较经典的胰十二指肠切除术相比具有手术时间短、出血量少和术后并发症少的优点。

OBJECTIVE:To explore the clinical value of the improved style of pancreatodeodenectomy. METHODS: We compared and analysed the operation time, the amount of postoperative bleeding, the postoperative untrition and postoperative complications of 24 cases of the improved pancreatoduodenectomy (Group B). RESULTS:The operation time of both Group A and Group B was (192.67±29.76) min, (228.18±36.80) min, t =3.417, P =0.002. The amount of bleeding during operation was (365.46±101.57) mL, (488.79±101.00) mL, t =3.796, P =0.001. The weight after operation increased up to (0.78±1.20) kg, (0.29±1.89) kg, t =1.011, P = 0.323. In Group A, There were no stoma ulcer and postgastrectomy bilereflux gastritis after operanon. In Group B, there were 3 cases of stoma ulcer and 8 cases of postgastrectomy bilereflux gastritis after operation. CONCLUSION: As compared to classical pancreatoduodenectomy, the improved pancreatoduodenectomy has the advantages of shorter operation time, less amount of bleeding and fewer complications after operation.