手工缝合和直线切割闭合器在胰体尾切除术中应用的对照研究

The application of hand-sewn and stapler in distal pancreatectomy: a retrospective study

目的:研究在胰体尾切除术中手工缝合和直线切割闭合器封闭胰腺残端对术后胰瘘等并发症的影响。方法:2011年4月至2014年1月收治158例胰腺病变患者,行胰体尾切除术,其中97例在开腹手术中采用手工缝扎胰腺残端,61例采用直线切割闭合器封闭胰腺残端,分析两组患者的临床相关胰瘘发生率。结果:直线切割闭合器组患者的术后临床相关胰瘘发生率为27.9%(17/97),手工缝合组为29.9%(29/61),两组间差异无统计学意义(P>0.05)。两组患者均无围手术期死亡。结论:在胰体尾手术中,使用直线切割闭合器封闭胰腺残端,胰瘘发生率与手工缝合相似。直线切割闭合器封闭胰腺残端是一种安全、有效、快捷的技术方法。

Objective： To determine the influence of hand-sewn and stapler in distal pancreatectomy on the postoperative complication. Methods： One hundred and fifty eight patients with pancreatic lesions, who underwent distal pancreatectomy in our hospital from April 2011 to January 2014, were consecutively collected. Of the 158 patients, hand-sewn was used in 97 patients （61.4%） and stapler closure in 61 patients （38.6%） after distal pancreatectomy. Clinical related pancreatic ifstula rate was compared between two groups. Results：Clinical related pancreatic ifstula was found in 29.9%（29/97） patients of hand-sewn group and 27.9%（17/61） patients of stapler closure group with no difference （P〉0.05） between two groups. No deaths occurred in two groups. Conclusion：The incidence of pancreatic ifstula by stapler or hand-sewn closure for distal pancreatectomy is similar, and stapler closure is a safe method.