不同胰管引流方式在胰肠吻合术后的疗效比较

The effect of different drainage of pancreatic duct after pancreaticojejunostomy

目的探讨不同胰管引流方式对胰肠吻合术后胰瘘发生的影响。方法回顾性地分析122例胰十二指肠切除患者的临床资料,122例中36例胰管内置管外引流,67例胰管内置管内引流,19例胰管内未置管引流。结果胰管内置管引流103例中21例(20.4%)发生胰瘘,胰管内置管外引流36例中4例(11.1%)发生胰瘘,胰管内置管内引流67例中17例(25.4%)发生胰瘘;而19例胰管内未置管引流病例中5例(26.3%)发生胰瘘。胰管引流组术后胰瘘发生率与胰管非引流组比较无统计学差异(P>0.05)。胰管内引流组术后胰瘘发生率与胰管外引流组比较无统计学差异(P>0.05)。结论胰十二指肠切除术中胰肠吻合时胰管内安置引流与否似与术后胰瘘的发生率无明显关系。

Objective To study the effect of different medthods of pancreatic duct drainage on prevention of pancreatic fistula after pancreaticoduodenectomy. Methods The clinical records of 122 patients who underwent standard pancreaticoduodenectomy were analyzed,retrospectively.The stented drainage of pancreatic duct was used in 103 of 122patients,including stented external drainage of pancreatic duct in 36 patients,and stented internal drainage of pancreatic duct in 67 patients;and without stented drainage in 19 patients. Results Pancreatic fistula was identified in 21of 103 patients in the drained group（4 in the stented external drainaged group and 17 in the stented internal drainaged group）,and in 5 of 19 patients in the nondrained group.The incidence of pancreatic fistula in the drained group（20.4%） had no significant difference compared with the nondrained group（26.3%,P0.05）,and the incidence of pancreatic fistula in the stented external drained group（11.1%） had no significant differenced compared with the stented internal drained group（25.4%,P0.05）. Conclusions Comparing the incidence of pancreatic fistula from both groups,the authors believe that the stented drainage of pancreatic duct does not significantly reduce the incidence of pancreatic fistula after pancreaticoduodenectomy.