捆绑式胰胃吻合术

目的 介绍一种新型的胰胃吻合术--捆绑式胰胃吻合术(binding pancreaticogastrostomy,BP6),并探讨其应用价值.方法 对2008年5月至10月收治的15例患者行胰十二指肠切除并采用BPG.其中胰头癌7例、十二指肠癌2例、肿块型慢性胰腺炎伴胰管结石1例、壶腹癌1例、胆囊癌1例、胰岛细胞瘤1例、胆总管下端癌2例.BPG的操作包括4个主要步骤:胰腺残端游离;胃后壁切开及荷包缝线预置;胃前壁切开;胰胃吻合(浆肌层捆绑和黏膜捆绑).结果 全组手术均顺利完成,无死亡.并发症包括:并发少量胸腔积液1例,胃排空障碍2例,胆漏2例,均经保守治疗痊愈,全组未出现胰胃吻合口漏.结论 应用BPG能够有效地预防吻合口漏的发生,从而显著提高胰十二指肠切除术的安全性.

Binding pancreaticogastrostomy

Objective To discuss the value of a new technique of the binding pancreaticogastrostomy(BPG) in pancreaticoduodenectomy. Methods From May 2008 to October 2008,15 patients were performed with BPG, included pancreatic head cancer in 7 cases, duodenal edenocarcinoma in 2 cases, mass-type chronic pancreatitis with pancreatolithiasis in 1 case, ampullary carciloma in 1 case, gallbladder cancer in 1 case, islet cell tumor in 1 case and cholangiocarcinoma in 2 cases. The mainprocedures of BPG included:isolating remnant pancreas; slitting partial posterior wall of stomach and preplaced with seromuscular purse-string suture;cutting gastric anterior wall; performing pancreaticogastrostomy (binding of outer seromuscular and inner mucous layer of stomach ). Results The procedures were successful in t5 patients. Postoperative complications included small amount of pleura] effusion in 2 cases, delayed gastric emptying in 2 cases and bile leakage in 2 cases. All patients were cured in 2 weeks. No mortality and anstomosis leakage occurred. Conclusion The application of BPG technique can prevent the anastomosis leakage and improve the safety for pancreaticoduodenectomy.