胰十二指肠切除术中胰消化道重建方式对术后胰瘘发生的影响

The Comparation of Different Pancreaticoenteric Reconstructions Designed to Prevent Pancreatic Fistula after Pancreatoduodenectomy

胰十二指肠切除术被认为是治疗壶腹周围良恶性肿瘤的一种成熟安全的术式,但其术后并发症的发生率仍高,而术后胰瘘是最常见的并发症之一。本文回顾并比较了目前为防止胰瘘发生而设计的各种胰消化道重建术式效果的相关数据,旨在通过对各项大样本研究,meta分析,前瞻性研究,回顾性研究以及随机对照实验进行客观严格的分析而寻找最有效的吻合术式。但遗憾的是,世界范围内目前并没有就任何一种术式较其他方法存在优越性达成共识。

Pancreaticoduodenectomy (PD) has become an increasingly matured and safe operation for selected patients with benign and malignant periampullary disorders. However, the postoperative morbidity rate is still high. Pancreatic fistula (PF) is the most problematic common complication after PD. This article reviews and compares the available data on the outcome of various methods of pancreaticoenteric reconstruction designed for the prevention of PF. This paper is designed to do a critical analysis of clinical literature including large series, meta-analyses, and prospective, randomized controlled trials (RCTs) in order to compare the different pancreaticoenteric anastomosis and get the best management. As a result, there is no universal agreement as to whether one procedure is safer and less prone to PF than the others.