胰体尾切除术中胰腺断端处理方式对比分析

Comparative analysis of the treatment of the pancreatic remnant in distal pancreatectomy

目的:对比胰体尾切除术中不同方式封闭胰腺断端的疗效。方法:回顾性分析158例接受胰体尾切除术患者资料,根据胰腺断端处理方式将病人分为手工缝合组(52例)、切割闭合器组(22例)和切割闭合器联合手工缝合组(31例),比较术后胰瘘发生率、术后住院时间、再次手术、死亡率等指标。结果:联合组胰瘘发生率小于手工缝合组及闭合器组,联合组住院时间少于手工缝合组,闭合器组1例再次手术,三组均无围术期死亡。结论:胰体尾切除术中采用直线切割闭合器联合手工缝合关闭胰腺断端与单纯手工缝合及闭合器相比,更有效防止术后胰瘘发生,缩短住院时间。

Objective:To compare the effect of different closure methods of the pancreatic remnant in distal pancreatectomy.Methods:The clinical data of 158 patients who received distal pancreatectomy were analyzed retrospectively.Patients were divided into hand-sewn closure group(52 cases),stapler group(22 cases)and stapler closure combined with hand-sewn closure group(31 cases)according to the treatment of the pancreatic remnant.The incidence of postoperative pancreatic fistula,length of stay,re-operation and mortality were compared.Results:The incidence of pancreatic fistula in the combined group was lower than that in the hand-sewn group and the stapler group.The length of hospitalization in the combined group was less than that in the hand-sewn group.The stapler group was operated again in one case,and none of the three groups died within 30 days after operation.Conclusion:The use of stapler closure combined with hand-sewn closure to treatment of the pancreatic remnant is more effective in preventing the occurrence of postoperative pancreatic fistula and shortening the length of stay than that of hand-sewn closure and stapler closure alone in distal pancreatectomy.