胰肠、胆肠连续吻合技术在胰十二指肠切除术中应用效果评价

Effect of continuous suture to pancreatic duct and bile duct with intestinal canal in pancreaticoduodenectomy

目的:探讨胰十二指肠切除术中采用连续吻合技术进行胰肠、胆肠吻合的可行性及安全性。方法:将46例行胰十二指肠切除的胰头部及胆管病变患者随机分为连续吻合组及常规吻合组,分别采用采用间断吻合及Poly线连续缝合技术处理胆肠及胰肠吻合口,比较两组患者手术时间、吻合时间、术后胰瘘发生率、住院时间等。结果:两组手术时间比较,无显著性差异;胰肠吻合组吻合时间为39min,连续吻合组吻合时间为22min,连续吻合组少于间断吻合组;连续吻合组术后胰瘘发生率为0,间断吻合组胰瘘发生率为13.04%,连续吻合组少于间断吻合组(P<0.05);连续吻合组住院时间平均为19d,间断吻合组住院时间平均为26d,连续吻合组少于间断吻合组(P<0.05)。结论:采用Poly线连续吻合技术进行胰肠、胆肠吻合能够减少胰十二指肠切除术后患者胰瘘的发生,并改善临床手术治疗效果。

Objective：To investigicoate the safety and feasibility of continuous suture to pancreatic duct and bile duct with intestinal canal in pancreaticoduodenectomy.Methods：46 patients with disease of pancreas and bile duct were randomly divided into continuous suture group and interrupted suture group,pancreatic duct and bile duct with intestinal canal were anastomose by interrupted suture in interrupted suture group and were anastomose by continuous suture Prolene suture line in continuous suture group,the time of operation,anastomosis and staying in hospital were contrasted,and ratio of pancreatic fistula was observed.Results：The time of operation was identical in two groups,the time of anastomosis was 39 min and taying in hospital was 26 days in continuous suture group,and was 22 min and 19 days in continuous suture group,the time of anastomosis was short in continuous suture group compared with the interrupted stuture group（ P0.05）,the ratio of pancreatic fistula was 0 in continuous suture group and 13.04% in interrupted suture group,the ratio of pancreatic fistula was lower in continuous suture group（P0.05）.Conclusion：Continuous suture to pancreatic duct and bile duct with intestinal canal in pancreaticoduodenectomy could decrease ratio of pancreatic fistula and improve effect of operation.