胰十二指肠切除术的技术改进

目的 探讨改进胰十二指肠切除术，预防术后并发症，提高手术疗效的方法。方法 采用保留幽门、胰管空肠粘膜吻合＋胰肠遮盖套入式吻合、胰管支撑外流充分切除胰钩突的术式，并观察其疗效。结果 全组未发生胰瘘及胰断面出血。保留幽门胰十二批肠切除术（ＰＰＰＤ）者有１例术后发生胃潴留，其余胃排空正常。结论 ＰＰＰＤ只要操作得当，可避免术后胃潴留。胰肠遮盖套入式吻合操作简便，可防止术后胰瘘、胰断面出血等并发症。

Some Technical Improvements of Pancreaticoduodenectomy

Objective\ To explore the way of prevention of postoperative complications and promotion of the curative effect by technical improvements of pancreticoduodenectomy.\ Methods\ The procedure was performed with some technical improvements as follow: preservation of the pylorus, pacreatico\|jejunstomy with pancreatic section surface covered,and fulls resection of unciform process.\ The curative effect were evaluated.\ Results\ Only one patient had gastric retension postoperatively in preservation of pylorus pancreaticoduodeneostomy(PPPD) group.\ All cases had no severe complications such as pancreatic fistula,bleeding at pancreatic section.\ The survival time after operation were 6 to 38 months.\ Conclusion\ Provided the procedure was performed properly, gastric retension could be avoided.\ Pancreaticoduodenectomy with improvements is simple and safe for prevention of postoperative complications.