胆胰液分流预防胰十二指肠切除术后胰瘘的价值

目的：探讨胆胰液分流预防胰十二指肠切除术后胰瘘的价值。方法；对91例胰十二指肠切除术患胰、胆、胃消化直重建时分别采用改良Roux-en—Y吻合术、总胆管放置T型引流管和胰管内放置引流管3种胆胰液分流术治疗，同时用未行胆胰液分流术45例作对照。结果：胰十二指肠切除术后行胆胰液分流术91例的胰瘘发生率为2．2％(2／91)，未行胆胰液分流术45例的胰瘘发生率为15．5％(7／45)（P＝0.00065)。应用改Roux－en—Y吻合术6例，胰管内放置引流管26例，无1例出现胰瘘；总胆管放置T型引流管59例，2例出现胰瘘。结论：胆胰液分流是预防胰十二指肠切除术后胰瘘发生的重要环节。

The value of bilipancreatic shunt to prevent pancreatic fistula after pancreatoduodenectomy

Objective:To explore the value of bilipancreatic shunt to prevent pancreatic fistula after pancreatoduodenectomy.Methods:The authers applied three kinds of bilipancreatic shunt:modified Roux en Y type anastomosis,T type drainage tube in common bile duct,drainage tube in pancreatic duct.Result of treatment was contrasted with non bilipancreatic shunt.Results:The incidence of pancreatic fistuta was 2.2% in this group with bilipancreatic shunt,and the contrast group 15.5%(P=0.00065).Modified Roux en Y anastomosis was used in 6 patients,drainage tube in pancreatic duct in 26 patients,no pancreatic fistula happened;T type drainage tube in common bile duct in 59 patients,2 pancreatic fistula happened.Conclusion:Bilipancreatic shunt is an important method to prevent pancreatic fistula after pancreatoduodenectomy.