肠腔减压预防胰十二指肠切除术胰漏的作用(附53例报告)

目的总结分析53例胰十二指肠切除术患者,置肠腔减压管预防胰漏的发生。方法本文总结2003年10月至2007年4月行胰十二指肠切除术53例,其中上腹部挤压伤2例,胰头癌12例,胆管下段癌及十二指肠乳头癌39例。吻合方式:采用胰腺残端空肠端侧吻合25例,胰管空肠端侧吻合28例。53例均采用Prolene线行胰肠吻合,空肠腔内置入引流管,自失功肠袢侧壁戳创引出腹壁,肠袢侧壁戳创口与腹壁间固定。结果术后无一例发生胰漏,1例因腹腔内有少量出血经保守治疗痊愈,1例因基础疾病致呼吸功能不全于术后30天放弃治疗,自动出院后死亡。结论胰肠吻合术中置肠腔内减压预防胰漏的发生是可行的,该术式可作为临床进一步研究预防胰漏的发生提供实践依据。

To evaluate the effect of jejunum cavity drainage to prevent the pancreatic leakage in pancreaticoduodenectomy(a report of 53 cases)

Objective To study the possible effect of jejunum cavity drainage to prevent the pancreatic leakage in the patients with pancreaticoduodenectomy(PD).Methods 53 cases of PD performed during the time from October 2003 to April 2007 were reviewed.It included 2 cases severe trauma at upper abdominal,12 cases of carcinoma at the head of pancreas,39 cases of carcinoma at the inferior of common bile duct and papilla of duodenum.Types of pancreaticojejunostomy(PJ) included remnant pancreatico-jejunum end-to-side anastomosis and pancreatic duct-jejunum end-to-side anastomosis.PJ in all of 53 cases were used by prolene suture,and drainage duct were put into the jejunum which were used pancreaticojejunal reconstruction.Results No pancreatic leakage ocurred.1 case with abdominal cavity bleeding were cured with transfusion and hemostatic agents.1 case of respiration failure due to primary respiratory disease were given up continuing treating in ward and died at the 30th day during postoperation.Conclusion The jejunum cavity drainage has effect on preventing the pancreatic leakage in PD.This method can provid the clinic surgery with the practical evidence of studying on the pancreatic leakage