Braun式吻合在腹腔镜下远端胃切除术中的应用

Application of Braun type anastomosis in laparoscopic distal gastrectomy

目的:探讨Braun式吻合在腹腔镜下远端胃切除术中的可行性及应用价值。方法:回顾分析2014年11月至2016年5月应用腹腔镜下远端胃切除术的50例胃癌患者的临床资料,对照组25例采用BillorthⅡ式吻合,观察组25例采用BillorthⅡ式吻合+Braun式吻合,比较2组手术情况及术后相关并发症。结果:2组胃癌根治术均在腹腔镜下顺利完成。2组手术时间、术中出血、切口长度、清扫淋巴结数目无显著性差异(均P>0.05),观察组住院时间短于对照组(P<0.05)。观察组术后反流性胃炎发生率显著低于对照组(P<0.05)。结论:Braun吻合在远端胃切除中能有效降低碱性反流性胃炎和十二指肠残端破裂等并发症,减少患者住院时间,值得临床推广。

Objective To explore thefeasibility and application value of Braun type gastrectomy. Methods： From November 2014 to May 2016,the clinical data of 50 patients with gastric carcinoma receivinglaparoscopic distal gastrectomy was retrospectively analyzed. 25 cases in control group were treated by25 cases in observation group were treated by Billorth type # anastomosis plus Braun type anastomosis. The operation-relatedindicators and postoperative complications were compared between the two groups. Results： Radical gastrectomy successfully completed under laparoscopy. There were no significant differences in operative time,intraoplength and the number of lymph node dissection between the two groups （ all P〉 0. 05 ）. The hospitalizatiogroup was shorter than that in the control group （ P 〈 0. 05 ） . The incidence of reflux gastritis in the observation group was significantly lower than that in the control group （ P 〈 0. 05 ） . Conclusion： Braun type anastomosis in laparoscopic distal gastrectomy can effectively prevent complications such as alkaline gastric reflux and duodenal stump rupture,reduce the length ofstay,which is worthy of clinical promotion.