胰瘘发生假说到捆绑式胰肠吻合的临床运用

From the Hypothesis of Pancreatic Fistula to the Clinical Use of Binding Pancreaticojejunostomy

为避免术后胰瘘的发生,在过去的100年间提出了多种胰肠吻合重建方式,但哪种方法最好一直备受争议.胰肠吻合后吻合针距间存在可能的间隙,这个问题或许成为胰肠吻合口瘘的爆发点,而且存在贯穿浆肌层缝合的胰腺表面外露的吻合针眼,如果缝针贯穿胰管小分支,胰液可能从针眼流出.这一假说构成了捆绑式胰肠吻合的基础.捆绑式胰肠吻合是一种安全、有效的预防术后胰瘘的吻合方式.

Over the past 100 years, Many techniques have been proposed for the reconstruction of the pancreaticodigestive anastomosis to prevent the development of a postoperative pancreatic fistula, but which is the best approach is still highly debated. The problem with the anastomosis techniques is that there is always a potential gap between the adjacent stitches, which could become the breaking point of pacreaticoenteric anastomosis leakage. Furthermore, there are needle holes on the surface of the anastomotic site after needle penetrating the sero-muscular layer. In case the needle penetrates a small branch of pancreatic duct, pancreatic juice could leak from the needle hole. Such a hypothesis forms the basis of the binding pancreaticojejunostomy. Binding pancreaticojejunostomy is a safe and effective technique that avoids the primary complication of pancreatic anastomosis leakage.