胰十二指肠切除术胰胆液引流方式的改进

Improvement of draining the pancreatic juice and bile in pancreatoduodenectomy

目的：探讨预防胰十二指肠切除术后胰瘘的方法。方法：在 Ｃｈｉｌｄ 术式基础上附加胰胆液分隔外引流。结果：自１９８６ 年１０ 月至１９９８ 年１０ 月连续行胰十二指肠切除术３１ 例，术后无胰瘘发生。结论：这种引流方法既可将胰液与胆液、肠液分隔开，避免胰液引起的自身消化作用；又可将胰液、胆液和肠液均引出体外，减轻空肠襻内压力，对预防术后胰瘘发生起重要作用。

Objective:To evaluate the validity of our method used for preventing pancreatic fistula formation in pancreatoduodenectomy.Methods:The pancreatoduodenectomy (Child procedure)with the individual external drainage of pancreatic juice and bile.Results:Thirty one patients underwent pancreatoduodenectomy with this method of drainage from October 1986 to October 1998.No pancreatic fistula occurred in this series.Conclusions:This type of drainage separates the pancreatic juice from the bile and intestinal contents to prevent the pancreatic zymogens from being activated,and allows total drainage of the pancreatic juice,bile and intestinal contents out of the body and lowers intraluminal pressure of the jejunal loop.It is useful in the prevention of postoperative pancreatic fistula formation.