后壁加固缝合改良胰肠吻合在胰十二指肠切除中的应用价值

The Application Value of Modified Pancreaticojejunostomy with Posterior Wall Reinforcement Suture in Pancreaticoduodenectomy

目的探究后壁加固缝合改良套入式胰肠吻合在胰十二指肠切除中的应用价值。方法随机选择2019年1月—2020年8月该院收治的60例进行胰十二指肠切除手术的患者,采用随机数字表法将其平均分为观察组和对照组,每组30例。对照组患者在胰十二指肠切除后进行常规黏膜黏膜吻合治疗,观察组进行后壁加固缝合改良套入式胰肠吻合术进行治疗。对比疗效。结果观察组手术时间为(342.25±42.33)min,术中出血量为(421.03±52.37)mL,住院时间为(18.39±5.29)d,对照组手术时间为(389.67±62.47)min,术中出血量为(422.06±51.74)mL,住院时间为(29.17±7.31)d,观察组手术时间低于对照组,差异有统计学意义(t=3.441,P<0.05);观察组住院时间低于对照组,差异有统计学意义(t=6.543,P<0.05);两组术中出血量差异无统计学意义(t=0.076,P>0.05)。观察组发生胰漏6例,肺部感染4例,消化道感染8例,出血7例;对照组发生胰漏15例,肺部感染6例,消化道感染9例,出血9例;两组胰漏发生率差异有统计学意义(χ^(2)=5.934,P=0.014),两组肺部感染发生率差异无统计学意义(χ^(2)=0.480,P=0.488),两组消化道感染发生率差异无统计学意义(χ^(2)=0.082,P=0.774),两组出血发生率差异无统计学意义(χ^(2)=0.340,P=0.559)。结论后壁加固缝合改良套入式胰肠吻合术可以减少胰十二指肠患者并发症的发生,和整体手术情况都优于进行常规黏膜黏膜吻合治疗的患者。

Objective To explore the application value of a modified sheathed pancreaticojejunostomy with posterior wall reinforcement suture in pancreaticoduodenectomy.Methods From January 2019 to August 2020,60 patients undergoing pancreaticoduodenectomy were randomly selected and divided into observation group and control group,with 30 cases in each group,by random number table method.Patients in the control group underwent conventional mucosal and mucosal anastomosis after pancreaticoduodenectomy,and the observation group underwent a modified sheathed pancreaticojejunostomy with posterior wall reinforcement suture.Contrast efficacy.Results The operation time of the observation group was(342.25±42.33)min,the intraoperative blood loss was(421.03±52.37)mL,and the hospital stay was(18.39±5.29)d,the operation time of the control group was(389.67±62.47)min,and the intraoperative blood loss was(422.06±51.74)mL,hospitalization time(29.17±7.31)d,operation time of observation group was lower than control group,the difference was statistically significant(t=3.441,P<0.05);hospitalization time of observation group was lower than control group,the difference was statistically significant(t=6.543,P<0.05);there was no statistically significant difference in intraoperative blood loss between the two groups(t=0.076,P>0.05).In the observation group,there were 6 cases of pancreatic leakage,4 cases of lung infection,8 cases of gastrointestinal infection,and 7 cases of hemorrhage;the control group had 15 cases of pancreatic leakage,6 cases of lung infection,9 cases of gastrointestinal infection,and 9 cases of hemorrhage;the ncidence of of pancreatic leakage was statistically significant(χ^(2)=5.934,P=0.014),there was no statistically significant difference in the incidence of lung infection between the two groups(χ^(2)=0.480,P=0.488),and there was no statistically significant difference in the ncidence of gastrointestinal infection between the two groups(χ^(2)=0.082,P=0.774),there was no statistically significant difference in the incidence of bleeding between the two groups(χ^(2)=0.340,P=0.559).Conclusion The modified sheathed pancreaticoje junostomy with posterior wall reinforcement suture can reduce the occurrence of complications in patients with pancreaticoduodenum,and the overall surgical situation is better than that of patients undergoing conventional mucosal mucosal anastomosis.