褥式交锁缝合在胰空肠吻合术中的应用

目的 探讨在胰十二指肠切除胰空肠吻合术中，采用褥式交锁缝合法防止胰空肠吻合口瘘的可行性。方法 对51例行胰十二指肠切除术的患者，在经典胰管空肠黏膜端侧吻合口前后壁加缝一层胰腺断端前后壁包膜，与空肠浆肌层切口前后壁浆肌层1号丝线褥式交锁缝合，缝线距胰断端与空肠浆肌切口约1cm。胰管内放置一段长约15cm的硅胶管，另一端置于空肠腔内，利用胰肠吻合处的缝线将硅胶管固定。胰管空肠黏膜吻合用3-0丝线．缝合3～6针。结果 51例患者均无胰瘘、胆瘘、腹腔感染及术后大出血等严重并发症发生。随访1个月至5年，无胆管炎、吻合口溃疡发生，无腹泻等胰腺外分泌功能不足症状。结论 胰空肠吻合时采用褥式交锁缝合法可有效防止胰肠吻合口瘘。

Mattres apposition suture using in pancreaticojejunostomy

Objective To evaluate the feasibility of Mattress apposition sut ure for preventing pancreatic fistula in pancreaticojejunostmy.Methods 51 cases received child's procedure and circle Mattress apposition suture under jejunal chorin after pancreaticojejunostmy.The suture sites respectively apart from the cut surface of jejunal chorion and the distal end of pancreas about 1cm.A sili caglue tude (about 15cm)was implanted into pancretic duct and fixed with silk, the other side of tube was placed into jejunum.The anastomosis was sutured abou t 3~6 pins with 3-0 silk.Results There were no severe complications such as pa ncreative fistula?biliary fistula?abdominal abscess and postoperative massive hemorrhage occured in the 51 cases.All patients were followed-up with a range o f month to 5 years,no one had cholecystitis,anastomotics ulcer and dysfunction symptom of pancreatic exocrine secretion.Conclusion Underwent circle Mattres apposition suture under jejunal chorion after pancreaticojejunostmy can prevent pancreatic fistula effectively.