改良胰管空肠端侧吻合在胰十二指肠切除术中的应用

The application of modified end-to-side pancreaticojejunostomy in pancreaticoduodenectomy

目的通过与其他吻合术式比较,探讨改良胰管空肠端侧吻合在胰十二指肠切除术中的应用价值。方法分析我院于2009年1月至2011年5月进行的203例因恶性肿瘤行胰十二指肠切除术的患者,其中A组86例,行改良胰管空肠端侧吻合;B组68例,行套入式胰肠端侧吻合;C组49例,行套入式胰肠端端吻合。分别比较胰肠吻合手术时间、术后胰瘘等并发症情况。结果 A、B、C三组胰肠吻合时间分别为(10.6±2.8)min、(19.9±3.6)min及(20.6±3.7)min,A组吻合时间显著低于其他两组(P<0.05)。术后胰瘘发生率A组最低,为1.1%(1/86),B组为4.4%(3/68),C组为6.1%(3/49)。结论胰管空肠端侧吻合操作简便省时,术后并发症发生率低,是胰十二指肠切除术中胰肠吻合的一种良好方法。

Objective To evaluate the applied value of modified end-to-side pancreaticoieiunostomv inpancreatieoduodenectomy by comparing it with other pancreaticoiejunostomy methods. Methods From January 2009 to May 2011,203 cases underwent different types of pancreaticoieiunostomy due to malignant tumor were analyzed retrospectively. All the patients were divided into three grnups, group A included 86 cases underwent modified end-to-side pancreaticoieiunostomy, group B included 68 cases underwent end-to-side invaginated pancreaticoieiunostomy, group C included 49 cases underwent end-to-end invaginated pancreaticoieiunostomy. Data including the operative time for pancreaticoieiunostomy and complications such as pancreatic fistula after surgery were compared. Results The operative time for pancreaticoieiunostomy in group A, B and C were （ 10.6± 2.8 ） min, （ 19.9 ± 3.6 ） rain and （ 20.6 ± 3.7 ） min respectively. The operation time for oancreaticoieiunostomy in group A was signieantly shorter than that of the other two groups. The incidence of pancreatic fistula in grnup A was 1.1% （ 1 / 86 ）, which was lower than that of group B （ 4.4%, 3 of 68 ） and group C （6.1%, 3 of 49 ）. Conclusion Modified end-to-side pancreaticoieiunostomy is easy to conduct and saving time with low incidence of complications, which may be a valuable method for pancreaticoieiunostomy in panereaticoduodenectomy.