胰胃及胰肠吻合在胰腺中段切除术中的应用

目的 探讨胰腺中段切除术中胰胃、胰肠两种吻合方式对患者术后疗效及近期并发症的影响.方法 回顾性分析单中心2013年5月至2015年5月25例胰腺中段切除术患者的临床资料,按重建方式分为胰胃吻合组(n=14)和胰肠吻合组(n=11),胰管与胃或肠黏膜唇状开口均以磁感应线式缝合方法吻合,比较两组术后胰瘘发生率、住院时间等指标.结果 两组患者基线资料具有可比性;术后胰瘘发生率、住院时间比较差异无统计学意义;所有患者均未发生吻合口出血.2例近端胰腺残端瘘给予充分引流,同时给予奥曲肽、肠外营养等保守治疗痊愈出院.结论 胰腺中段切除术能较好地保持胰腺功能,胰胃与胰肠吻合术均是安全的.

Application of pancreaticogastrostomy and pancreaticojejunostomy in central pancreatectomy

Objective To assess the effects of Pancreaticogastrostomy and Pancreaticojejunostomy in Central Pancreatectomy on patients in terms of immediate postoperative complications and long-term nutritional status. Methods Retrospective analysis the data of 25 patients with Central Pancreatectomy in a single surgical group of our department from May 2013 to May 2015. Reconstruction methods are Pancreaticogastrostomy and Pancreaticojejunostomy. The pancreatic duct were consistent with stomach or intestinal mucosa lips openings by magnetic induction line suture. Two groups of patients were compared in terms of postoperative pancreatic fistula, bleeding, hospital stay. Results There were no statistical difference in postoperative pancreatic leakage complications and hospital stay in the two groups. All the 25 patients did not have anastomotic bleeding. Two cases of proximal pancreatic stump leakage were observed, and cured by administration of adequate drainage, octreotide acetate injection, parenteral nutrition and so on. Conclusions Central Pancreatectomy can better maintain the pancreas function. Pancreaticogastrostomy and Pancreaticojejunostomy are safe.