两种不同胰十二指肠切除术残胰重建方式的比较

目的探讨预防胰十二指肠切除术(pancreaticoduodenectomy,PD)术后胰漏的合理胰腺残端处理方式.方法回顾性分析该院10年间行PD治疗的壶腹周围癌肿患者的临床资料.观察围手术期的情况和术后胰漏及由此引发的腹腔感染的发生率.结果两组病人间围手术期情况的差异无统计学意义,胰管空肠端侧吻合组与胰腺空肠端端吻合组术后胰漏发生率分别为3.9%和12.6%(P=0.044).腹腔感染发生率分别为1.3%和9.7%(P=0.026),相关死亡率为0和5.8%.结论胰管空肠端侧吻合重建确实可靠,能够有效地降低PD后胰漏的发生.

Comparision of two different reconstruction of residual pancreas after PD

[Objective] To explore ideal technique of pancreaticojejunostomy in preventing pancreatic fistula after pancreaticoduodenectomy(PD). [Methods] The data of patients of pancreatic and periampullary carcinoma that received PD were retrospectively analyzed in our hospital. End-to-side duct-to-mucosa pancreaticojejunostomy(Group A) and end-to-end pancreaticojejunostomy(Group B) were performed randomly. [Results] The perioperation status was not significantly different between the 2 groups. The morbidity of pancreatic fistula was 3.9% and 12.6%, that of severe sepsis was 1.3% and 9.7%, and the associated mortality was 0 and 5.8% between Group A and Group B respectively. [Conclusion] Duct-to-mucosa pancreaticojejunostomy was safe and strict, and effectively declined incidence of pancreatic fistula.