胃癌扩大根治术中胰腺残端的处理

Improved Management of the Distal Pancreatic Stump in the Extended Radical Resection of Gastric Cancer

目的 降低胃癌扩大根治联合远端胰腺切除术后胰漏的发病率。 方法 自 1992年 8月至 2 0 0 0年 2月 ,对 15例患者施行远端胰腺切除时 ,近端稍外凸 ,呈“ >”形 ,然后结扎主胰管 ,创面止血。利用代胃空肠制作带血管蒂浆肌瓣 ,用纤维蛋白胶将浆肌瓣与胰腺残端贴敷后丝线缝合 ,以保护胰腺残端。 结果 未发生 1例胰漏或腹腔感染。 结论 浆肌瓣有利于促进胰断面愈合 。

Objective To reduce the risk of pancreatic leakage in the extended radical resection of gastric cancer. [WT5”HZ]Methods[WT5”BZ] A new technique of distal pancreatectomy was applied from August, 1992 to February, 2000.The pancreas was transected in such a way that the proximal stump was left with a slightly convex surface.The main pancreatic duct was then ligated,achieving hemostasis on the cut surface with sutures.A pedicled seromuscular flap of the jejunum was used to cover the cut surface of the pancreas with the aid of fibrin glue. [WT5”HZ]Results [WT5”BZ]No pancreatic leakage or abdominal infection was observed in the 15 patients, who received the operation.[WT5”HZ] Conclusion [WT5”BZ]This approach provides a tight closure of the pancreatic stump after distal pancreatectomy in the extended radical resection for gastric cancer.