从胰肠吻合口并发症发生机制看胰颈直线切割闭合加连续单层胰肠吻合术的合理性

Rationality of pancreatic neck linear stapler closure combined with continuous single-layer pancreaticojejunal anastomosis technology based on the mechanism of pancreatic intestinal anastomosis complications

胰肠吻合术(PJ)是胰十二指肠切除术等胰腺手术的重要组成部分,既是技术难点,也是术后胰瘘等严重并发症的好发部位。为了更好地适应腹腔镜时代的新要求,简化PJ,提升其质量,笔者团队创新性地将胰颈直线切割闭合技术应用于胰腺离断,将连续单层缝合技术应用于PJ,取得了满意的初步效果。本文通过分析PJ常见并发症及其发生机制,提出高质量PJ的技术细节要求,阐述胰颈直线切割闭合加连续单层PJ的合理性。

Pancreaticojejunostomy(PJ)is an important component of pancreatic surgery such as pancreaticoduodenectomy.It is not only a technical difficulty,but also a common site for serious complications such as postoperative pancreatic fistula.In order to better adapt to the new requirements of the laparoscopic era,simplify PJ,and improve its quality,the author's team innovatively applied the pancreatic neck linear stapler closure technology to pancreatic transection,and applied continuous single-layer suture technology to PJ,achieving satisfactory initial results.This article proposes the technical details of high-quality PJ by analyzing its common complications and their mechanisms,and elaborates on the rationality of pancreatic neck linear stapler closure combined with continuous single-layer PJ.