大网膜包裹的胰腺残端捆扎术预防胰漏的临床疗效

Great omental wrapping of pancreatic stump to prevent pancreatic leakage

目的:探讨大网膜包裹的胰腺残端捆扎术预防胰漏是胰腺远端切除术(d i s t a l pancreatectomy,DP)术后胰漏的安全性及有效性.方法:回顾性对比分析2011-01/2014-02 61例行DP患者的临床病理资料,根据胰腺残端处理方式分为2组:A组(捆扎组,n=19):采用大网膜包裹胰腺残端捆扎术处理胰腺残端;B组(非捆扎组,n=42):采用手工缝合法和闭合器法联合处理胰腺残端.结果:61例患者中共有18例(29.5%)发生了胰漏,A组有2例(10.5%)发生了胰漏,2例均为B级胰漏,B组有16例(38%)发生了胰漏,其中A级胰漏11例,B级胰漏5例,C级胰漏1例,两组术后胰漏发生率差异有明显统计学意义(P=0.03).结论:大网膜包裹的胰腺残端捆扎术能有效预防DP后胰漏的发生率,是一种安全可行的胰腺残端处理方式.

AIM： To evaluate the safety and efficacy of great omental wrapping of pancreatic stump in preventing pancreatic leakage after distal pancreatectomy（DP）.METHODS： Clinicopathologic data for 61 patients who underwent DP from January 2011 to February 2014 were analyzed retrospectively. These patients were divided into two groups： A and B. Group A（n = 19） underwent DP with great omental wrapping of the pancreatic stump, and group B（n = 42） underwent DP with manual suture and closure.RESULTS： Of the 61 patients, 18（29.5%） had pancreatic leakage after operation, including two（10.5%） cases in group A（1 case of grade A and 1 case of grade B） and 16（38%） cases in group B（11 cases of grade A, 5 cases of grade B and 1 case of grade C）. The incidence of pancreatic leakage after operation had a significant statistical difference between the two groups（P = 0.03）.CONCLUSION： Great omentum wrapping of the pancreatic stump could effectively prevent pancreatic fistula after distal pancreatectomy, and it is a safe and feasible technique for pancreatic stump closure.