改良的套入式端侧吻合在胰肠吻合术中的临床应用

Application of modified end-to-side invaginated pancreaticojejunostomy

目的：探讨改良的套人式端侧吻合在胰肠吻合术中临床应用的可行性。方法：回顾2004年2月一2012年11月实施的31例胰十二指肠切除术（PD）患者的临床资料，其中男19例，女12例，平均年龄58（16～76）岁；胰头癌16例，壶腹癌5例，胆总管下段癌8例，十二指肠肿瘤2例，均采用胰十二指肠切除术及改良的套人式端侧胰肠吻合术，分析消化道重建后的恢复及并发症发生情况。结果：全组手术时间160～260min，术中出血100～500mL，总并发症发生率为12．9％，其中腹水2例，胰瘘2例，均给予保守治疗而治愈；无手术死亡，患者均治愈出院。结论：改良的套入式端侧吻合技术在胰十二指肠切除术的胰肠吻合术中具有操作简单，手术时间短，术后并发症少等优点，是胰肠吻合的一种有效改进。

Objective： To investigate the clinical applicability of modified end-to-side invaginated pancreaticojejunostom）a Methods： qlae clinical data of 31 patients undergoing pancreatoduodenectomy （PD） from February 2004 to November 2012 were reviewed. Of the 31 patients, 19 were males and 12 were females with average age of 58 （16-76） years; 16 cases had pancreatic head cancer, 5 had ampullary cancer, 8 had inferior common bile duct cancer, and 2 had duodenal tumors. PD and modified end-to-side invaginated pancreaticojejunostomy were performed in all patients. The postoperative recovery and incidence of complications after reconstruction of gastrointestinal tract of the patients were analyzed. Results： Of the entire group, the operative time was 160-260 min intraoperative blood loss was 100-500 mL, and the overall incidence of complications was 12.9%, including ascites and pancreatic fistula in 2 cases each, which were resolved by conservative therapy. There was no surgical death, and all patients were cured anddischarged from the hospital. Conclusion： The modified end-to-side invagination technique for post-PD pancreaticojejunostomy has the advantages of easier performance, shorter operative time and less postoperative complications, so it is an effective improvement ofpancreato-enteric anastomosis.