不同闭合方式在降低胰体尾切除术后并发症的效果观察

The effect of different closure methods on reducing complications after distal pancreatectomy

目的探讨手工缝合和切割闭合器(Endo-GIA stapler)处理胰腺残端对胰体尾切除术后并发症的影响。方法回顾性分析南昌大学第一附属医院2014年1月至2018年8月收治的行胰体尾切除术88例病人的临床资料,根据不同闭合方式分为:手工缝合组24例、开腹闭合器组40例及腹腔镜闭合器组24例,比较三组病人在术中相关指标、术后恢复情况及并发症等方面的差异。结果三组病人在术中出血量、术后住院时间、病理良恶性、住院费用等方面差异均无统计学意义(均P>0.05),三组病人总并发症发生率及胰瘘发生率差异也无统计学意义(P>0.05)。结论切割闭合器与腹腔镜均不能降低胰体尾切除术后总并发症发生率,也不能降低胰瘘发生率。

Objective To investigate the effect of manual suture and Endo-GIA stapler on complications of distal pancreatectomy.Methods The clinical data of 88 patients undergoing distal pancreatectomy in our hospital from January 2014 to August 2018 were analyzed retrospectively.According to different closure modes of pancreatic stump,the patients was divided into three groups,24 cases in the manual suture group,40 cases in the open resection group that used Endo-GIA stapler and 24 cases in the laparoscopic resection group that used Endo-GIA stapler,respectively.The operative indexes,postoperative recovery and complications of the three groups were compared.Results There were no significant difference between the three groups in blood loss,postoperative hospital stay,pathological types and medical costs(P>0.05);there were no statistically significant difference in complication rate and pancreatic fistula rate of the three groups(P>0.05).Conclusion Both Endo-GIA stapler and laparoscopic technique can not reduce the incidence of total complications after distal pancreatectomy,nor can they reduce the incidence of pancreatic fistula.