套入式胰胃双层吻合在胰十二指肠切除术中的临床应用

目的探讨胰十二指肠切除术中采用套入式胰胃吻合重建的手术指征、方法及疗效。方法回顾性分析我院1999年1月至2011年6月期间施行的胰十二指肠切除并行套入式胰胃吻合的39例患者的临床资料，均采用胰管内放置支撑引流管套入式胰胃双层间断吻合法。结果本组患者均顺利完成手术，平均手术时间为362min，术中输血量平均为330mL；术后住院时间平均为24d。住院期间1例（占2．5％）患者肺部感染、呼吸衰竭死亡；术后并发症5例（占12．8％），肺部感染2例，并胰胃吻合口出血1例，经抑酸止血治疗出血停止，切口感染3例，并切口裂开1例。结论套入式胰胃双层吻合是一种可靠有效的胰腺残端重建方式，合理地选择套八式胰胃吻合可以最大程度地减少胰十二指肠切除术后胰瘘的发生。

Reconstruction by Pancreaticogastrostomy Following Clinical Panereaticoduodenectomy

Objective To evaluate the operative indication and results of pancreaticogastrostomy following pancreaticoduodenectomy. Methods A retrospective study was carried out on the 39 cases of pancreaticoduodenectomy following pancreatieogastrostomy from January. 1999 to December.2011 about Departement of Seconder Tumor Surgery, First People Hospital in Kashi, on China. Results During this period,38 cases had undergone pancreaticogastrostomy with pancreaticoduodenectomy. The median operative time was（352.1~78.3） minutes. The median intraoperative blood transfusion was（611.3~301A）mL.The median postoperative length of stay was（26.2±12.1）days. Pancreatic anastomotic leakage didn＇t occurred in 39 patients, pulmonary infection occurred in 2 patients and 1 death after operative 4 days with 12.8%（1/39） Postoperative morbidity .Incision infection occurred in 3 patients and 1 disruption of wound. All of the complications were treated conservatively. Conclusion Pancreaticogastrostomy is a safer drainage procedure for the pancreatic stump after pancreaticodnodenectomy.