胰十二指肠切除术101例报告

Experience of 101 cases of pancreaticoduodenectomy.

目的 探讨降低胰十二指肠切除术后并发症发生率及手术死亡率的措施。方法 将单层吻合技术应用于 15例胰十二指肠切除术胰肠重建 ,33例施行保留幽门的胰十二指肠切除术 ,其余病例均行经典的胰十二指肠切除术 ,胰肠重建采用传统的双层吻合。结果 10 1例中术后出现并发症的有 2 7例 ,其中胰瘘 13例(12 9% )。住院期间死亡 4例 (3 8% )。应用单层褥式交锁缝合进行胰肠重建的 15例术后经过均良好 ,无一例并发胰瘘 ,亦无手术死亡。

Objective To investigate the ways how to decrease the morbidity and mortality of pancreaticoduodenectomy.Methods Single-layered anastomosis was applied in 15 cases of pancreatoenteric reconstruction and pyloric-preserving pancreaticoduodenectomy was performed in 33 cases.The experince was summarized.Results The postoperative morbidity rate was 26 6%(27/101),including 13 cases of pancreatic fistula.The in-hospital mortality rate is 3 8%( 4/101 ).The 15 cases in which single-layered anastomoses were used to accomplish pancreato-enteric reconstruction had no postoperative pancreatic fistula and no in-hospital death.Conclusion Single-layered anastomosis in pancreato-enteric reconstruction and pyloric-preserving pancreaticoduodenectomy are efficacious methods to decrease the postoperative morbidity.