Kissing式胰肠吻合术在267例胰十二指肠切除术中的应用

Experiences in use of kissing pancreatojejunostomy in 267 cases of pancreatoduodenectomy

目的:评价Kissing式胰肠吻合法在胰十二指肠切除术后胰肠吻合中的可行性、有效性及安全性。方法:回顾性分析2006年1月至2020年9月间行胰十二指肠切除并应用kissing式胰肠吻合法完成消化道重建的267例患者的临床资料。结果:术后并发症发生情况:B级胰瘘17例(6.37%),C级胰瘘6例(2.25%);术后30 d内无死亡病例。以胰管直径3 mm为界值进行比较,不同胰管直径组B级、C级胰瘘差异无统计学意义(15/140比8/127,P=0.20);以不同胰腺硬度为界值进行比较,不同胰腺硬度组B级、C级胰瘘差异亦无统计学意义(20/194比3/73,P=0.11)。结论:Kissing式胰肠吻合术易于开展,应用于细胰管、质地软的胰腺组织的胰肠吻合时胰瘘的发生率也并未增加。

Objective To investigate feasibility,efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods From Jan 2006 to Sep 2020,the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results Grade B postoperative pancreatic fistula(POPF)occurred in 6.37%,Grade C POPF in 2.25%of patients.There was no mortality within 30 days postoperatively as to pancreatic fistula,by cut-off of pancreatic duct diameter at 3mm,there was no significant difference between two subgroups(15/140 vs.8/127,P=0.20).also,when grouped by texture of the pancreas,no there was significant difference(20/194 vs.3/73,P=0.11).Conclusions Kissing pancreatojejunostomy is feasible and easy to perform.It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.