捆绑式胰肠吻合的改良及其在老年壶腹周围癌中的应用

目的：总结改良捆绑式胰肠吻合技术在老年壶腹周围癌行根治性手术中的疗效。方法：回顾分析17例采用改良捆绑式胰肠吻合技术行根治性胰十二指肠切除的老年壶腹周围癌患者，观察术后并发症。结果：17例采用改良捆绑式胰肠吻合技术行根治性切除者无1例发生胰瘘，无围手术期死亡。全组病例的1年，3年，5年生存率分别为52．9％(9／17)，29．4％(5／17)及11．8(2／17)。结论：改良捆绑式胰肠吻合技术和恰当的围手术期处理，有助于减少老年壶腹周围癌患者术后胰瘘等并发症及降低病死率。

Modification of binding pencreaticojejunostomy and its application in elderly patients with ampullar carcinoma

Objective:To summarize the effect of the modified binding pancreaticojejunostomy anastomosis technique in the operation for periampullar carcinoma in elderly patient.Methods:Modified binding pancreaticojejunostomy anastomosis technique was performed in 17 of 28 cases with periampullar carcinoma undergone radioal pancreatoduodenectomy and the complication was analyzed retrospectively from Mar.1999 to Jun.2003.Results:After one month to 5 years' follow-up,pancreatic leakage,abdominal infection and digestive tract fistula were not found,and no perioperative death occurred. The 1,3 and 5 years survival rates were 52.9%(9/17),29.4%(5/17) and 11.8%(2/17),respectively.Conclusion:The modified binding pancreaticojejunostomy anastomosis technique and appropriate treatment in peri-operative time may contribute to reduce postoperative pancreatic leakage and mortality rate in elderly patient.