石蕊试纸和吻合器在胰十二指肠切除术中的应用

Use of litmus paper and mechanical stapler in pancreaticoduodenectomy

目的探讨石蕊试纸和吻合器在胰十二指肠切除术中的应用价值。方法在24例胰十二指肠切除消化道重建过程中,采用下列措施预防吻合口漏:(1)改良套叠式胰空肠吻合术;(2)石蕊试纸检查胰腺断面和胰肠吻合口;(3)应用吻合器施行胆管空肠吻合及胃空肠吻合;(4)完成吻合后,在各吻合口周围喷撒纤维蛋白胶封闭剂。结果患者恢复良好,术后无1例胰漏、胆漏及肠漏。随访2个月～2年,各吻合口未发生狭窄。结论在胰十二指肠切除施行消化道重建过程中,应用石蕊试纸和吻合器,不仅明显缩短了手术时间,而且有助于减少吻合口漏等并发症,利于患者顺利康复。

Objective To investigate the clinical value of litmus paper and mechanical stapler in pancreaticoduodenectomy. Methods The following methods were used to prevent anastomotic leakage in alimentary tract reconstruction after pancreaticoduodenectomy for 24 patients： improved overlapping pancreatojejunostomy; management of the pancreatic stump and pancreatojejunostomy with litmus paper; choledochojejunostomy and gastrojejunostomy using mechanical stapler; and fibrin sealant for preventing potential anastomotic leakage. Results No anastomotic leakage occurred in 24 consecutive patients. Both biliary tract and digestive anastomosis were shown during a follow-up within 2 months to 2 years. Conclusions Litmus paper and mechanical stapler in alimentary tract reconstruction after pancreaticoduodenectomy may promote the recovery of patients by shortening operative time and preventing potential anastomoti＇c leakage.