胰十二指肠切除术的技术改进

目的总结胰十二指肠切除术的技术改进及成功经验。方法2002年6月~2004年12月施行胰十二指肠切除术27例,男17例,女10例,平均年龄50.0岁(32~69)。其中胰头癌13例,胆管下段癌7例,十二指肠乳头癌5例,慢性胰腺炎2例。手术技术改进点包括:胰肠三层吻合胰管内置、常规放置空肠减压管及空肠侧侧吻合等。结果平均手术时间414 m in(280~540),平均出血341.2 m l(100~1000)。6例术中输血,平均输血815.0 m l(450~1100),无手术死亡,未发生胆漏、胰漏及大出血。术后平均住院16.5 d(12~27)。结论改进胰头十二指肠切除的手术技术可以有效地预防术后并发症的发生。

TECHNIQUE IMPROVEMENT OF PANCREATICODUODENECTOMY

Objective To introduce our experience of pancreaticoduodenectomy with a modified surgical technique.Methods From Jun 2002 to Dec 2004,27 cases,17 males and 10 females,with a mean age of 50.0 years(range:32-69),were treated by pancreaticoduodenectomy in our department.All of the operations were done by the improved technique.The improvement included:three-deckduct-to-mucosal pancreaticojejunostomy,pancreatic catheter in jejunum,decompressing tube in the jejunal blind end,side-to-side jejunostomy.Result The mean operating time was 414 minutes(rang:280-540).The mean intraoperative blood loss was 341.2 ml(rang:100-1000).There was no mortality or complications such as biliary/pancreatic fistula or massive hemorrhage.The median postoperative hospital stay was 16.5 days(rang:12-27).Conclusions Our modified surgical technique in pancreaticoduodenectomy can effectively decrease postoperative complications.