中华普通外科学文献（电子版）
中華普通外科學文獻（電子版）
중화보통외과학문헌（전자판）
CHINESE JOURNAL OF GENERAL SURGERY(ELECTRONIC VERSION)
2008年
3期
201-205
,共5页
丁会民%QIN Xi-hu%朱峰%周新军
丁會民%QIN Xi-hu%硃峰%週新軍
정회민%QIN Xi-hu%주봉%주신군
胰十二指肠切除术%胰漏%吻合方式
胰十二指腸切除術%胰漏%吻閤方式
이십이지장절제술%이루%문합방식
Pancreaticoduodenectomy%Pancreatic lekage%Anastomotic methods
目的 探讨胰十二指肠切除术(PD)不同胰肠吻合方式对胰漏发生的影响.方法 回顾2002年2月至2007年5月154例行胰十二指肠切除术病例,分别采取胰肠套埋单层吻合105例,双层吻合49例,分析与胰漏相关危险因素及两组间胰漏差异原因.结果 胰漏发生率8.4% (13/154),Logistic回归多变量分析表明:男性、胰腺质地软、非单层胰肠吻合方式是3个与胰瘘相关的独立变量;两种吻合方式间胰漏(单层吻合, 4.8% vs 双层吻合, 16.4%)、术后并发症(单层吻合, 18.1% vs双层吻合, 32.7%)、术后平均住院时间(单层吻合, 18.45±7.11天vs 双层吻合, 22.75±9.73天)、质软胰腺中胰漏(单层吻合, 6% vs双层吻合, 27.6%)有统计学差异.结论 胰肠套埋单层吻合,特别是在质软胰腺中应用可明显减少胰漏发生率.
目的 探討胰十二指腸切除術(PD)不同胰腸吻閤方式對胰漏髮生的影響.方法 迴顧2002年2月至2007年5月154例行胰十二指腸切除術病例,分彆採取胰腸套埋單層吻閤105例,雙層吻閤49例,分析與胰漏相關危險因素及兩組間胰漏差異原因.結果 胰漏髮生率8.4% (13/154),Logistic迴歸多變量分析錶明:男性、胰腺質地軟、非單層胰腸吻閤方式是3箇與胰瘺相關的獨立變量;兩種吻閤方式間胰漏(單層吻閤, 4.8% vs 雙層吻閤, 16.4%)、術後併髮癥(單層吻閤, 18.1% vs雙層吻閤, 32.7%)、術後平均住院時間(單層吻閤, 18.45±7.11天vs 雙層吻閤, 22.75±9.73天)、質軟胰腺中胰漏(單層吻閤, 6% vs雙層吻閤, 27.6%)有統計學差異.結論 胰腸套埋單層吻閤,特彆是在質軟胰腺中應用可明顯減少胰漏髮生率.
목적 탐토이십이지장절제술(PD)불동이장문합방식대이루발생적영향.방법 회고2002년2월지2007년5월154례행이십이지장절제술병례,분별채취이장투매단층문합105례,쌍층문합49례,분석여이루상관위험인소급량조간이루차이원인.결과 이루발생솔8.4% (13/154),Logistic회귀다변량분석표명:남성、이선질지연、비단층이장문합방식시3개여이루상관적독립변량;량충문합방식간이루(단층문합, 4.8% vs 쌍층문합, 16.4%)、술후병발증(단층문합, 18.1% vs쌍층문합, 32.7%)、술후평균주원시간(단층문합, 18.45±7.11천vs 쌍층문합, 22.75±9.73천)、질연이선중이루(단층문합, 6% vs쌍층문합, 27.6%)유통계학차이.결론 이장투매단층문합,특별시재질연이선중응용가명현감소이루발생솔.
Objective To analyze the possible difference in the incidence of pancreatic leakage relative to two methods of pancreaticoduodenectomy(PD). Methods A retrospective review of 154 consecutive patients who underwent PD between Feb 2002 and May 2007 was carried out. 105 cases were used a single-deck invaginated pancreaticojejunostomy, 49 cases were double-deck invaginated.Risk factors associated with leakage were determined for all 154 cases and then outcomes for each group were compared. Results Leakage was observed in13 of 154 cases (8.4%).Uni-and multivariate analysis showed three independent risk factors for leakage : male gender;not using a single-deck invaginated pancreaticojejunostomy; soft pancreatic gland.The leakage rate in the single-deck group was 4.8%(5 of 105)and in the double-deck group was 16.4%(8 of 49,P=0.016).The postoperation complication was 18.1%in single-deck group while32.7%in the double-deck group.The mean length of stay after PD was longer in the double-deck group (22.75±9.73 days)as compared to the single-deck group (18.45±7.11 days). The leakage rate was 6%in the single-deck group vs 27.4%in the double-deck group(P=0.014).Conclusion The single-deck invaginated pancreaticojejunostomy decreases leakage significantly,particularly when a patient has soft pancreatic gland.
