多径路快速安全暴露门静脉和肠系膜上静脉在胰十二指肠切除术中的应用

Application of fast and secure multipath exposure of portal vein and superior mesenteric vein in pancreaticoduodenectomy

目的探讨多径路快速安全暴露门静脉(PV)和肠系膜上静脉(SMV)在胰十二指肠切除术中的应用效果。方法回顾性分析我院2005年10月至2013年10月80例行胰十二指肠切除术的胰头癌患者的临床资料,根据PV/SMV暴露方法的不同分为2组,每组40例,观察组采用多径路快速安全暴露法,对照组采用传统暴露法,对比2组疗效。结果观察组手术成功率为90.0%(36/40),显著高于对照组72.5%(29/40),观察组手术时间(360.6±58.7)min和术中出血量(600.4±36.8)mL均显著低于对照组(414.2±81.3)min和(788.8±57.9)mL,观察组3年死亡率65.0%(26/40),显著低于对照组86.1%(31/36),差异均具有统计学意义(P<0.05)。结论多径路快速安全暴露PV/SMV应用于胰十二指肠切除术中可提高手术成功率,缩短手术时间,减少术中出血量和术后不良反应,提高长期存活率。

Objective To investigate the application effect of fast secure multipath exposure of portal vein （ PV） and superior mesenter-ic vein （ SMV） in pancreaticoduodenectomy. Methods Retrospective analyzed the clinical data of 80 cases of pancreatic head cancer pa-tients who underwent pancreatoduodenectomy in our hospital from October 2005 to October 2013. According to the different PV/SMV expo-sure methods, they were divided into 2 groups with 40 cases in each group. The observation group used fast secure multipath exposure meth-od while the control group were given traditional method of exposure, and curative effect of the 2 groups were compared. Results In the ob-servation group, the success rate of operation was 90. 0%（36/40） which is significantly higher than 72. 5% （29/40） in the control group;in the observation group , operation time was （ 3 6 0 . 6 ± 5 8 . 7 ） min and intraoperative bleeding was （ 6 0 0 . 4 ± 3 6 . 8 ） mL which were＆amp;nbsp;significantly lower than that（414. 2 ± 81. 3）min and （788. 8 ± 57. 9） mL in the control group;3 year mortality rate in observation group was 65.0%（26/40） which was significantly lower than 86. 1% （31/36） in control group, these differences were statistically significant （P〈0. 05）. Conclusion Fast and secure multipath PV/SMV applied in pancreatoduodenectomy could improve the operation success rate, shorten the operation time, reduce the intraoperatve blood soss and postoperative adverse reactions, and improve the long-term survival rate.