羊肠线捆扎胰残端法在胰十二指肠切除术中的应用效果

目的研究应用羊肠线捆扎胰残端法在胰十二指肠切除术中的临床效果。方法将实施胰十二指肠切除的29例患者,在完成胰十二指肠切除及淋巴廓清后,将患者按2∶1随机分为研究组和对照组,研究组19例用0号羊肠线距胰残端2.5～3cm处捆扎胰残端,再行空肠单层套入式吻合,对照组10例行常规的胰空肠端端双层套入式吻合,2组术后进行临床效果对照。结果研究组19例术后无发生胰肠吻合口漏、胆漏及胰腺炎病例;对照组10例发生胰漏1例,胰周积液并感染1例。胰肠吻合时间研究组比对照组缩短近一半时间(P<0.01),胰腺残端失血量研究组明显比对照组减少(P<0.01)。结论应用羊肠线捆扎胰残端法可减少术中、术后胰腺残端出血,术野清晰,操作简便,节省时间,并可有效预防术后胰漏的发生。

Clinical effectiveness of catgut ligation of pancreatic stump in pancreatoeuteroanastomosis

Objective To study the clinical effectiveness of catgut binding pancreaticojejunostomy for pancrease duodenum resection.Methods Before catgut binding pancreaticojejunostomy,29 cases were divided into two groups.Study group:19 cases,the pancreatic stump was bound with 1-0 catgut at the distance of 2.5 to 3 cm away from the utsurface.Control group:10 cases were bind pancreaticojejunostomy and end-to-end pancreaticojejunal invagination.The clinical effectiveness of two groups were compared.Results No anastomotic leakage,bile leakage and pancreatitis were discovered in 19 cases of catgut binding pancreaticojejunostomy.1 case(10.00%)of anastomotic leakage,1 case(10.00%)of peripancreatic infection was observed in 10 cases of end-to-end pancreaticojejunal invagination.The operation time of binding pancreaticojejunostomy was half long as that of end-to-end pancreaticojejunal invagination(P<0.01).The pancreatic stump blood lost of binding pancreaticojejunostomy was significantly less than that of end-to-end pancreaticojejunal invagination(P<0.01).Conclusion Catgut binding pancreaticojejunostomy is an effective method,which can reduce blood lost,operation time and complications.