不同吻合方式对Partington术后胰瘘的影响

Relevance of different anastomosis patterns on incidence of pancreatic fistula after Partington operation

目的：探讨不同吻合方式对胰管-空肠Roux-en-Y术后胰瘘的影响。方法：回顾性分析1999年8月—2011年6月因慢性胰腺炎主胰管扩张行胰管-空肠Roux-en-Y术的47例患者临床资料。依胰肠吻合口的处理方法分为Prolene线连续缝合和间断缝合两组,分别观察两组术后胰瘘发生的情况及临床效果。结果：连续缝合组25例未出现胰瘘,间断缝合组22例4例发生胰瘘,两者差别具有统计学意义（P〈0.05）;术后随访3~5年,46例腹痛完全缓解。结论：胰管-空肠Roux-en-Y术中间断缝合容易发生胰瘘,Prolene线连续缝合能降低胰瘘发生率,且操作简单易行。

Objective： To investigate the relevance of different anastomosis patterns to the incidence of pancreatic fistula after Roux-en-Y pancreaticojejunostomy（PJ）. Methods： The clinical data of 47 patients with chronic pancreatitis and associated dilation of the main pancreatic duct undergoing Roux-en-Y PJ from Augest 1999 to June 2011 were retrospectively analyzed.According to the different anastomosis patterns（continuous or interrupted Prolene sutures）,the patients were divided into two groups,and then the incidence of pancreatic fistula and clinical outcomes of the two groups after surgery were analyzed,respectively. Results： No pancreatic fistula occurred in the 25 cases with continuous sutures,while 4 of the 22 cases with interrupted sutures developed pancreatic fistula,and the difference between the two group had statistical significance（P0.05）.The postoperative follow-up ranged from 3 to 5 years,and the abdominal pain was completely relieved in 46 cases. Conclusion： Interrupted suture is prone to developing pancreatic fistula after Roux-en-Y PJ.However,the continuous Prolene suture technique may reduce the incidence of pancreatic fistula and this procedure is also simple and easy to perform.