不同胰肠吻合方式的临床疗效分析

目的探讨胰十二指肠切除术中3种不同胰肠吻合方式的临床疗效。方法回顾分析2005年1月~2010年4月施行过的76例胰十二指肠切除术,按照胰肠吻合方式的不同将其分为胰管对肠黏膜吻合组、改良Child吻合组及捆绑式吻合组,分析各组的胰肠吻合时间、肛门排气时间、术后胰瘘率、腹腔出血率、消化道出血率、消化吸收障碍率等指标。结果 3组之间仅术后消化吸收功能障碍率有明显差异,胰管对黏膜吻合组明显低于另2组,而其他相关指标各组间均无统计学差异。结论胰十二指肠切除术后早期并发症与胰肠吻合方式无关,而胰管对肠黏膜吻合可以减少术后消化吸收功能障碍的发生,故值得临床推广。

Analysis of therapeutic effect of different pancreaticojejunostomy

Objective To investigate the therapeutic effect of three different types of pancreaticojejunostomy in pancreaticoduodenectomy.Methods 76 cases of pancreaticoduodenectomy in our hospital between January 2005 and April 2010 were analyzed retrospectively.These cases were classified duct-to-mucosa pancreaticojejunostomy group,modified Child pancreaticojejunostomy group and Peng′s binding pancreaticojejunostomy group according to difference of pancreaticojejunostomy.The average time of anastomosis,the venting time,the rates of pancreatic leakage,gastrointestinal bleeding,intra-abdominal hemorrhage and digestive functional disturbance were investigated.Results The rate of digestive functional disturbance in duct-to-mucosa pancreaticojejunostomy group was obviously lower compared with which in the other two groups(P<0.01).There was no significant difference of the average time of anastomosis,the venting time,the rates of pancreatic leakage,gastrointestinal bleeding and intra-abdominal hemorrhage among these groups(P>0.05).Conclusion The type of pancreaticojejunostomy has nothing to do with the early postoperative complications after pancreaticoduodenectomy.Application of duct-to-mucosa pancreaticojejunostomy could reduce digestive functional disturbance rate,thus worth being widely used clinically.