胰十二指肠切除术后两种胰管空肠黏膜吻合方法的比较研究

Comparing two methods of anastomosis of pancreatic duct and jejunal mucous membrane in pancreaticoduodenal resection

目的探讨胰十二指肠切除术后2种胰管空肠黏膜吻合方法对胰漏发生率的影响。方法回顾性研究本院2005年1月～2010年1月60例胰十二指肠切除术(PD)后患者的临床资料,分析和比较传统和改进胰空肠黏膜吻合术后胰漏的发生率。结果 35例传统胰管空肠黏膜吻合组患者中有3例8.5%(3/35)出现胰漏,改进胰管黏膜吻合组无1例发生胰漏0%(0/25),2者有显著差异(P<0.05);胰瘘相关死亡率为33.3%(1/3)。结论改进的胰管空肠黏膜吻合方法能够显著降低胰漏的发生,胰肠吻合方式是影响胰瘘的独立危险因素。

Objective To compare the incidence of＇ pancreatic fistula between the two meth- ods of anastomosis of pancreatic duct and jejunal mucous membrane. Methods The clinical data of 60 patients underwent pancreaticoduodenal resection （PD） between January 2005 and January 2010 in our hospital were retrospectively analyzed. The incidence of pancreatic leakage in traditional and im- proved pancreatic jejunal mucosal anastomosis were analyzed and compared. Results There were 3 cases （8.5%） with pancreatic fistula in the group of traditional anastomosis of pancreatic duct and je- junal mucous membrane, and there were no pancreatic fistula （0%） in the group of modified anasto- mosis of pancreatic duct and jejunal mucous membrane. There was significant difference between the two groups（P 〈0.05）. The mortality of patients with pancreatic fistula was 33.3% （1/3）. Conclu- sion The modified method of anastomosis of pancreatic duct and jejunal mucous membrane can sig- nificantly decrease the incidence of pancreatic fistula. The methods of anastomosis of pancrease and je- junum is the independent risk factor which may result in pancreatic fistula.