胰十二指肠切除术中胰胃吻合及吻合器应用效果观察

目的 探讨胰胃吻合术及吻合器在胰十二指肠切除术(PD)中的应用价值.方法 将我院2008年12月-2011年12月收治的壶腹周围癌40例分为观察组(n=22)和对照组(n=18),均采用经典PD术式行脏器游离、切除.对照组行手工胰肠及胆肠、胃肠吻合;观察组采用捆绑式胰胃吻合术行胰液内引流,采用吻合器行胆肠、胃肠吻合.记录两组手术时间、吻合时间,比较两组术后住院天数及并发症发生情况.结果 与对照组比较,观察组手术时间及吻合时间缩短、术后住院天数减少(P＜0.05,P＜0.01);两组术后并发症发生率比较差异无统计学意义(P＞0.05).结论 胰胃吻合术及吻合器在PD中应用安全、易行,可明显缩短手术时间,提高手术效率.

Clinical Observation on the Effect of Pancreas-stomach Inosculation and Application of Anastomat in Pancreaticoduodenectomy

Objective To explore the value of pancreas-stomach inosculation and application of anastomat in pancreaticoduodenectomy.Methods 40 patients during December 2008 and December 2011 with periampullary carcinoma,divided into therapy group（n=22） and control group（n=18）,underwent organ freeing and ablation by classic PD technique.The control group were treated with manual pancreaticoduodenectomy while the therapy group with binding pancreaticoduodenectomy with pancreatic juice internal drainage and chol-intestines and gastrointestinal inosculation by anastomat.The time of operation and inosculation of the two groups were recorded,and the hospital days and complications of the two groups were compared.Results The time of surgery,anastomoses and hospital days afteroperation of therapy group were shorter than those of control group（P〈0.05,P〈0.01）,and there was no statistical significance in comparing postoperative complications of the two groups（P〉0.05）.Conclusion Pancreaticogastrostomy and anastomat using in PD are simple,safe and effective which could shorten the operation time and improve efficiency of operation,but the long-term therapeutic effect should be further observed.