改良胰管空肠端侧吻合在胰十二指肠切除术中的应用

目的 通过与其他吻合术式比较,探讨改良胰管空肠端侧吻合在胰十二指肠切除术中的应用价值.方法 分析我院于2009年1月至2011年5月进行的203例因恶性肿瘤行胰十二指肠切除术的患者,其中A组86例,行改良胰管空肠端侧吻合;B组68例,行套入式胰肠端侧吻合;C组49例,行套入式胰肠端端吻合.分别比较胰肠吻合手术时间、术后胰瘘等并发症情况.结果 A、B、C三组胰肠吻合时间分别为( 10.6±2.8) min、( 19.9±3.6) min及(20.6±3.7) min,A组吻合时间显著低于其他两组(P＜0.05).术后胰瘘发生率A组最低,为1.1％( 1/86),B组为4.4％( 3/68),C组为6.1％ (3/49).结论 胰管空肠端侧吻合操作简便省时,术后并发症发生率低,是胰十二指肠切除术中胰肠吻合的一种良好方法.

The application of modified end-to-side pancreaticojejunostomy in pancreaticoduodenectomy

Objective To evaluate the applied value of modified end-to-side pancreaticojejunostomy in pancreaticoduodenectomy by comparing it with other pancreaticojejunostomy methods.Methods From January 2009 to May 2011,203 cases underwent different types of pancreaticojejunostomy due to malignant tumor were analyzed retrospectively.All the patients were divided into three groups,group A included 86 cases underwent modified end-to-side pancreaticojejunostomy,group B included 68 cases underwent end-to-side invaginated pancreaticojejunostomy,group C included 49 cases underwent end-to-end invaginated pancreaticojejunostomy.Data including the operative time for pancreaticojejunostomy and complications such as pancreatic fistula after surgery were compared.Results The operative time for pancreaticojejunostomy in group A,B and C were(10.6 ± 2.8)min,(19.9±3.6)min and(20.6±3.7)min respectively.The operation time for pancreaticojejunostomy in group A was signicantly shorter than that of the other two groups.The incidence of pancreatic fistula in group A was 1.1%(1 /86),which was lower than that ofgroup B(4.4%,3 of68)and group C(6.1%,3 of49).Conclusion Modified end-to-side pancreaticojejunostomy is easy to conduct and saving time with low incidence of complications,which may be a valuable method for pancreaticojejunostomy in pancreaticoduodenectomy.