荷包套入式胰空肠双重吻合预防胰十二指肠切除术后胰漏

目的探讨胰十二指肠切除术的方法及术后并发症的防治。方法回顾性分析1985-08～2007-08施行的206例胰十二指肠切除术的手术情况及术后并发症,胰肠吻合全部采用荷包套入式胰空肠双重吻合。结果206例胰十二指肠切除术均手术成功,无胰漏发生,无围手术期死亡,胆漏4例,上消化道出血3例,肠系膜上动脉切断1例,腹部切口裂开2例。结论胰十二指肠切除术技术的提高和胰肠吻合技术的改进是防止术后胰漏发生的关键。荷包套入式胰空肠双重吻合方法,可以有效的预防胰十二指肠切除术后胰漏的发生。

Invaginated double-layer anastomosis of pancreaticojejunostomy in the prevention of pancreatic leakage following pancreaticoduodenectomy

Objective To explore the surgical method of pancreaticoduodenectomy and prevention & treatment of complications after operation.Method The 206 cases underwent pancreaticoduodenectomy from Aug.1985 to Aug.2007 were reviewed.The invaginated double-layer pancreaticojejunostomy was performed in all the cases.Result All the cases were operated on succcefuly,pancreatic leakage and perioperative death didn't occur.The complications occured in 4 cases of bile leakage,3 cases of upper gastrointestinal hemorrhage,1 case of seission of superior mesentric artery and 2 cases of incision dehiscence.Conclusion The invaginated double-layer anastomosis of pancreaticojejunostomy can prevent pancreatic leakage.Enhance and improvement of pancreaticoduodenectomy and anastomosis are the keys to prevent pancreatic leakage.