分层解剖在根治性胰十二指肠切除术中的应用

目的：探讨分层解剖在根治性胰十二指肠切除术中的应用价值和临床疗效。方法：我科自2010年3月～2012年10月共行胰十二指肠切除术16例，现回顾分析分层解剖根治手术的临床资料。结果：本组16例患者均顺利完成手术，平均手术时间（6．5±0．2） h，平均术中出血量约（200±30）ml，平均淋巴结清除数（24．2±1．4）个，平均淋巴结阳性数（3．6±1．2）个；平均住院日（22±1．5）d，术后切口均甲级愈合，1例出现胰肠吻合口瘘。结论：分层解剖在根治性胰腺十二指肠切除术中可以进行程序化解剖清扫淋巴脂肪组织，减少手术时间和术中出血量，降低术中血管骨骼化清扫难度，值得临床推广应用。

Sequential layered dissection in radical pan-creatoduodenectomy

Objective：To investigate the clinical value of applying se-quential layered dissection route to radical pancreatoduodenectomy . Methods： The clinical data were reviewed in 16 patients undergone pan-creatoduodenectomy between March 2010 and October 2012 in our depart-ment.Results： The total 16 patients went through successful operation . The mean operative time was 6.5 h,and mean intraoperative blood loss 200 ml.Dissection of the total number of lymph node and positive lymph node was respectively 24.2 and 3.6 on average.Average hospital stay was 22 days,and the total patients achieved level-A would healing after proce-dure except for occurrence of anastomosis fistula in one case.Conclusion：Applying sequential layered dissection route to radical pancreatoduode-nectomy may lead to standardized dissection of the lymph nodes ,reduced operative time and intraoperative blood loss as well as easy clearing of skeletonization of the vasculature in operation , which is worthy of wider clinical recommendation.