胰十二指肠切除术中胰肠吻合缝线选择的研究进展

Research progress in the selection of pancreaticojejunostomy suture in pancreaticoduodenectomy

胰十二指肠切除术(PD)是壶腹周围占位性疾病最主要的治疗方式。PD后胰瘘是临床悬而未解的难题,严重影响手术安全性。临床上已报道多种方式降低胰瘘发生率,如改进胰肠吻合手术方式、使用生物密封胶、应用生长抑素类似物、持续腹腔冲洗等,但胰瘘发生率仍维持在5%~30%。PD后胰瘘的危险因素众多。缝合材料的合理选择是其重要因素,也是影响手术疗效的重要因素。笔者分析PD中各种缝线的特点及不足,旨在为提高手术安全性,降低PD后胰瘘发生率提供帮助。

Pancreaticoduodenectomy(PD)is the mainstay of treatment for periampullary space‐occupying disease.The occurrence of pancreatic fistula after PD is still an unsolved clinical problem,which seriously affects the safety of surgery.Various methods have been reported in clinical practice to reduce the incidence of pancreatic fistula,such as improving pancreaticoenteric anastomosis,using biological sealants,applying somatostatin analogs,and continuous peritoneal irrigation,etc.,but the incidence of pancreatic fistula remains at 5%−30%.There are many risk factors related to pancreatic fistula after PD,in which reasonable selection of suture materials is an important factor and also an important factor affecting the curative effect of surgery.The authors analyze the characteristics and shortcomings of various sutures used in PD,in order to provide help to improve the safety of surgery and reduce the incidence of pancreatic fistula after PD.