高选择迷走神经钳夹术在保留幽门胰十二指肠切除术中的应用

Application of highly selective vagotomy clamp in pylorus-preserving pancreatoduodenectomy

目的探讨高选择迷走神经钳夹术在保留幽门胰十二指肠切除术(PPPD)中的应用及临床可行性。方法将43例行PPPD患者随机分为钳夹组(21例)和对照组(22例)。对照组行常规PPPD;钳夹组在常规PPPD基础上加用高选择迷走神经钳夹术,动态观察2组术后第2、4、6个月上腹不适和体质量增加情况。结果钳夹组术后2、4、6个月出现上腹不适的例数略少于对照组,且术后2个月体质量增加量显著高于对照组。结论高选择迷走神经钳夹术可有效防止PPPD患者出现上腹灼痛、食欲缺乏等不良反应,有利于术后恢复,增加体质量,改善预后,具有临床可行性。

Objective To explore the application of highly selective vagotomy clamp in pylorus-preserving pancreatoduodenectomy（PPPD） and its clinical feasibility.Methods Forty-three patients capable of being conducted PPPD were randomly grouped into clamp group（n=21） and control group（n=22）.The condition of postoperative upper abdominal discomfort and weight gain was respectively observed in 2 groups on 2,4 and 6 months.Results The cases of upper abdominal discomfort after operation in clamp group were slightly shorter than those in the control group on the 2nd,4th and 6th months,and weight gain significantly higher than that in the control group 2 months after operation.Conclusion Highly selective vagotomy clamp can effectively prevent the occurrence of adverse reactions like scorching pain in upper abdomen and poor appetite in PPPD patients,and it is conductive to postoperative recovery,weight gain and prognostic amelioration,so it has clinical feasibility.