胰十二指肠切除术中胰肠吻合和胰胃吻合对术后胰腺功能的影响比较

目的探讨胰十二指肠切除术中胰肠吻合和胰胃吻合对术后胰腺功能的影响。方法选取行胰十二指肠切除术患者62例,其中传统胰肠吻合组33例,嵌入式胰胃吻合组29例。比较2组患者术后的营养状况、胰管直径变化及胰腺功能。结果 2组患者的术后胰管直径均较术前明显扩张,差异有统计学意义(P<0.05)。2组患者术后空腹血糖水平及糖化血红蛋白水平与术前比较,差异无统计学意义。胰肠吻合组术后新发糖尿病2例(6.06%),胰胃吻合组为2例(6.90%),差异无统计学意义。胰肠吻合组术后10例患者出现不同程度的脂肪泻(30.30%),胰胃吻合组为8例(27.59%),差异无统计学意义。结论胰肠吻合和胰胃吻合对胰十二指肠切除术后患者的一般营养状况、胰管直径以及胰腺内外分泌功能均无明显影响。

Objective To explore the influences between pancreaticojejunostomy and pancreatogastrostomy on pancreatic function after operation. Methods 62 patients undergoing pancreaticoduodenectomy were selected, including 33 cases of pancreaticojejunostomy and 29 cases ofpancreatogastrostomy. The nutrition status, pancreatic duct diameters and pancreatic function between two groups were compared. Results The pancreatic duct diameters of patients in two groups were enlarged after operation（P〈0.05）, and there was no difference between two groups. The levels of fasting blood glucose and HbA1c of patients in two groups were unchanged after operation. There were two cases of new-onset diabetes in pancreaticojejunostomy group（6.06%） and two cases in pancreatogastrostomy group（6.90%）. There were ten cases of catarrhal dysentery in pancreaticojejunostomy group（30.30%） and eight cases in pancreatogastrostomy group（27.59%）. Conclusion Both pancreaticojejunostomy and pancreatogastrostomy had no influence on pancreatic function after operation.