胰腺切除术后胰管和胃粘膜吻合术

为了减少胰腺部分切除后胰瘘和出血的并发症。作者在4例胰十二指肠切除术和1例胰体尾切除术中采用胰胃吻合术(胰管和胃粘膜吻合)。该术式采用二层吻合法,外层为胰腺和胃后壁浆肌层缝合,使胰腺切面与胃后壁紧贴。胃后壁相应部位戳一小孔,将胰管和胃粘膜吻合完成手术。4例术后恢复良好,1例术后死于心肝肾功能衰竭,与手术方式无关。该术式是一项安全的胰液引流方法,且有许多方法上的优点。

ANASTOMOSIS OF THE PANCREATIC DUCT AND THE GASTRIC MUCOSA AFTER PANCRETECTOMY

Since 1994, five patients have undergone pancreaticogastrostomy after pancreatectomy at our institution. Pancreaticoduodenectomy was performed for ampullary carcinoma (3 patients) and chronic pancreatitis (1 patient), distal pancreatectomy was performed for 1 patient with obstructed pancreatic duct and pseudocyst. The pancreaticogastric anastomosis was constructed by suturing the pancreatic duct to the gastric mucosa. Four patients recovered uneventfully and one died of multiple system failure not related to the asastomosis. Literature and our experience suggest that pancreaticogastrostomy with a mucosal anastomosis may have technical advantage and therefore merits more widespread application.