改良胰胃吻合在胰头十二指肠切除术中重建消化系的应用

Modifi ed pancreaticogastrostomy for digestive tract reconstruction after pancreatoduodenectomy

目的:探讨胰十二指肠切除术中将改良胰胃吻合应用于重建消化系的手术安全性及其近期疗效.方法:收集我院2006-03/2009-07采用改良胰胃吻合胰十二指肠切除术治疗44例患者的临床资料,对其进行回顾性分析.结果:患者手术时间200-420(平均260)min,失血量150-1600(平均260)mL,无手术死;出现胰瘘2例(4.55%,2/44),经保守治疗后痊愈;5例出现胃排空障碍(11.36%,5/44);胰腺残端出血1例(2.27%,1/44);无手术伤口感染或腹腔感染的病例;术后住院时间13-27(平均15)d;随访率100%,随访6mo至3年,无远期手术并发症发生.结论:改良胰胃吻合使胰十二指肠切除成为一种操作容易、安全可靠的术式,值得各级医院推广.

AIM： To investigate the safety and efficacy of modified pancreaticogastrostomy （PG） for digestive tract reconstruction after pancreaticoduodenectomy （PD）. METHODS： A total of 44 patients who underwent modified PG after PD at our hospital from March 2006 to July 2009 were retrospectively analyzed. RESULTS： The mean operation time was 260 min （range： 200-420 min）. The mean blood loss was 260 mL （range： 150-1600 mL）. No mortality occurred postoperatively. The postoperative pancreatic leakage occurred in 2 patients （4.55%, 2/44）, both of which were cured by conservative management. Delayed gastric emptying occurred in 5 patients （11.36%, 5/44）. The bleeding of the pancreatic stump occurred in 1 patient （2.27%, 1/44）. No surgical wound infection or abdominal infection occurred. The mean postoperative length of stay （LOS） was 15 days （range： 13-27 days）. The postoperative follow-up, which lasted from 3 months to 3years, was carried out in all patients, and no longterm complications were found. CONCLUSION： Modif ied PG after PD is a safe and easy procedure for digestive tract reconstruction.