捆绑式胰肠吻合术对胰十二指肠切除术后胰瘘的预防作用

目的　观察捆绑式胰肠吻合术对胰十二指肠切除术 (PD)后胰瘘的预防作用。方法　对 2 0 0 1年以来采用捆绑式胰肠吻合术完成的 2 6例PD与 1993年～ 2 0 0 0年采用其他胰肠吻合方式完成的 82例PD进行回顾性对比分析。结果　全组胰瘘的发生率为 13 9% ( 15 / 10 8) ,其中捆绑式胰肠吻合组无胰瘘发生 ,而胰 -空肠套入式端端吻合组及胰管空肠粘膜端侧吻合组胰瘘的发生率分别为 2 4 6% ( 14 / 5 7)、4 0 % ( 1/ 2 5 ) ,捆绑式胰肠吻合组胰瘘发生率显著低于胰 -空肠套入式端端吻合组 (P <0 0 1) ,而与胰管空肠粘膜端侧吻合组差异无显著性 (P >0 0 5 )。结论　捆绑式胰肠吻合术操作简便 ,预防胰瘘效果可靠 ,值得推广。

The Effect of Binding Pancreaticojejunostomy on Prevention of Pancreatic Leakage after Pancreaticoduodenectomy

Objective To investigate the effect of binding pancreaticojejunostomy (BPJ) on the prevention of the pancreatic leakage after pancreaticoduodenectomy(PD). Methods The clinical data of 108 patients who underwent PD, including 26 cases of BPJ since 2001 and 82 cases of other type of pancreaticojejunostomy from 1993 to 2000,were retrospectively analyzed. Results The frequency of pancreatic leakage in this series was 13.9%. No pancreatic leakage occurred in BPJ group, whereas the frequency of pancreatic leakage in end-to-end invaginated pancreaticojejunostomy group and duct-to-mucosa pancreaticojejunostomy group was 24.6%(14/57) and 4.0%(1/25),respectively. The frequency of pancreatic leakage in BPJ group was significantly lower than that in end-to-end invaginated pancreaticojejunostomy group(P<0.01), but there was no significant difference between BPJ group and duct-to-mucosa pancreaticojejunostomy group(P>0.05). Conclusion BPJ may be effective in the prevention of the pancreatic leakage after PD.