改良式胰肠吻合方法对术后胰瘘影响的病例对照研究

The change of postoperative pancreatic fistula in modified duct-to-mucosa in pancreaticojejunostomy： a retrospective case control study

目的探讨胰十二指肠切除术中改良式胰肠吻合方法对术后胰瘘的影响。方法本文回顾性分析了四川大学华西医院自2008年4月至2017年9月同一术者收治的行胰十二指肠切除或扩大胰十二指肠切除术符合纳入标准的122例患者的临床资料．其中2008年4月至2010年12月30例患者为对照组，2011年1月至2017年9月92例患者为观察组，2组均采用胰管．空肠黏膜吻合方法进行胰肠吻合，但观察组吻合方法较对照组进行了改良。术后对2组临床相关胰瘘的发生情况进行比较。结果观察组92例临床相关胰瘘率为0％（0／92），对照组30例临床相关胰瘘率为1313％（4／30）。结论采用改良后的胰管．空肠黏膜吻合方法进行胰肠吻合可减少患者术后临床相关胰瘘的发生。

Objective To explore the change of postoperative pancreatic fistula （POPF） in modified pancreaticoenteric anastomosis in pancreaticoduodenectomy. Methods This paper retrospectively analyzed clini- cal data of 122 patients who suffered pancreaticoduodenectomy or enlarged pancreaticoduodenectomy from Apr. 2008 to Sep. 2017 in West China Hospital of Siehuan University. All surgeries were operated by a surgeon. 30 patients from Apr. 2008 to Dec. 2010 were divided to control group, and 92 patients from Jan. 2011 to Sep. 2017 were the experimental group. Pancreatic duct-jejunum mucosa anastomosis was adopted in the two groups, but the method in experimental group was modified. Clinically relevant POPF was compared between the two groups. Re- sults The rate of clinically relevant POPF was 0% （0/92） in the experimental group, while it was 13.3（4/30） in the control group. Conclusion Modified technique for duct-to-mucosa pamcreatieojejunostomy can reduce the incidence of POPF.