胰十二指肠切除术中胰胃吻合及吻合器的应用效果观察

Clinical observation on the application effects of pancreaticogastrostomy and using stapler in pancreaticoduodenectomy

目的探讨胰腺胃吻合术及吻合器在胰十二指肠切除术(PD)中的应用价值。方法 40例患者按照知情同意原则分为观察组(n=22)和对照组(n=18例),均采用经典PD术式行脏器游离、切除。对照组行手工胰肠、胆肠及胃肠吻合;观察组采用捆绑式胰腺胃吻合术行胰液内引流,采用吻合器行胆肠、胃肠吻合,记录两组手术时间、吻合时间,比较两组术后住院天数及并发症发生情况。结果与对照组比较,观察组手术时间及吻合时间缩短、术后住院天数减少(P<0.05),而两组术后并发症比较差异无统计学意义(P>0.05)。结论胰腺胃吻合术及吻合器在胰十二指肠切除术中应用简单、安全、易行,可明显缩短手术时间,提高手术效率,但远期疗效尚待进一步观察。

Objective To investigate the application values of pancreaticogastrostomy and using stapler in pancreaticoduodenectomy（PD）.Methods Forty patients were divided into two groups according to principle of informed consent.22 patients using binding pancreaticogastrostomy for internal drainage of pancreatic duct and stapler for choledochojejunostomy and gastroenterostomy in PD as observation group and 18 patients using traditional PD as control group were observed.Recorded the operation time and anastomosis time,and compared the hospital stay time and complications incidence between the two groups.Results Compared with control group,the operation time and anastomosis time of observation group were shorter,the hospital stay time decreased（P0.05）,while the difference of postoperative complications between two groups showed no statistical significance（P0.05）.Conclusion Pancreaticogastrostomy and stapler using in PD is simple,safe and effective,which could reduce the operation time and anastomosis time,decrease the hospital stay time and improve the efficiency of operation,but the long-term effect should be further observed.