CAJ | 학술논문

目的比较胰十二指肠切除(pancreatoduodenectomy,PD)后胰胃吻合术与胰肠吻合术的近期临床效果.方法回顾性分析中山大学附属第一医院胃肠胰腺外科从2006年4月至2010年12月间因十二指肠癌和胰头肿瘤施行胰十二指肠切除术37例(其中胰胃吻合组19例,胰肠吻合组18例)患者的临床资料.胰胃吻合组患者采用将胰腺残端套入胃后壁方式吻合,胰肠吻合组采用传统套入式吻合.比较两组的平均手术时间、术中估计失血量、术后胰瘘、病死率及术后平均住院时间等情况.结果胰胃吻合组和胰肠吻合组的平均手术时间[(372.1±79.5) min比(351.0±69.2) min,P＞0.05]、术中估计失血量[(693.5±412.8)ml比(645.1±488)ml,P＞0.05]、术后胰瘘(2/19例比2/18例,P＞0.05),病死率(1/19例比1/18例,P＞0.05)和平均术后住院时间[(1 7.5±8.9)d比(16.1± 7.6)d,P＞0.05]差异无统计学意义.结论 PD后胰胃吻合并发症率不会高于胰肠吻合,可以作为PD后的另一种消化道重建的选择.
목적 비교이십이지장절제(pancreatoduodenectomy,PD)후이위문합술여이장문합술적근기림상효과.방법 회고성분석중산대학부속제일의원위장이선외과종2006년4월지2010년12월간인십이지장암화이두종류시행이십이지장절제술37례(기중이위문합조19례,이장문합조18례)환자적림상자료.이위문합조환자채용장이선잔단투입위후벽방식문합,이장문합조채용전통투입식문합.비교량조적평균수술시간、술중고계실혈량、술후이루、병사솔급술후평균주원시간등정황.결과 이위문합조화이장문합조적평균수술시간[(372.1±79.5) min비(351.0±69.2) min,P＞0.05]、술중고계실혈량[(693.5±412.8)ml비(645.1±488)ml,P＞0.05]、술후이루(2/19례비2/18례,P＞0.05),병사솔(1/19례비1/18례,P＞0.05)화평균술후주원시간[(1 7.5±8.9)d비(16.1± 7.6)d,P＞0.05]차이무통계학의의.결론 PD후이위문합병발증솔불회고우이장문합,가이작위PD후적령일충소화도중건적선택.
Objective To compare the feasibility and safety of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy. Methods A retrospective study was performed on 37 patients who underwent pancreaticoduodenectomy for duodenal carcinoma or pancreatic head tumors at the First Hospital of Sun Yat-sen University from April 2006 to December 2010.Pancreatic anastomosis was carried out either using pancreaticogastrostomy (n＝ 19) or pancreaticojejunostomy (n=18).The operative time,intraoperative bHood Hoss,postoperative pancreatic Heak,mortaHity and Hength of hospitaH stay were compared between the two groups. ResuHts The mean operative time,intraoperative bHood Hoss,incidence of pancreatic fistuHa,mortaHity rate and mean Hength of postoperative hospitaH stay were (372.1 ±79.5) min vs (351.0±69.2) min; (693.5± 412.8) mH vs (645.1±488)ml; 10.5％ (2/19) vs 11.1％ (2/18); 5.3％ (1/19) vs 5.6％ (1/18); and (17.5± 8.9)d vs (16.1± 7.6)d,respectively.The differences between the two groups were not statistically significant.Conclusion Pancreaticogastrostomy appears to be a feasible and safe alternative to pancreaticojejunostomy for the pancreatic remnant after pancreaticoduodenectomy.