CAJ | 학술논문

目的通过动物实验探索Kissing式胰肠吻合的可行性和安全性,明确胰管、黏膜愈合的病理过程.方法通过测定胰肠吻合后吻合口耐受压,求证该吻合的严密性；通过吻合后不同时间的手术探查、胰肠管造影和病理学检查证实吻合后胰腺残端与空肠黏膜之间愈合情况和病理演变过程.结果所有实验犬均顺利完成胰肠吻合术,耐受压测定均在90 cm H2O以上,各时间段处死的实验犬均见吻合口紧密,无出血、瘘口,造影见胰管与肠腔连续,充盈良好,未见造影剂外渗现象.病理切片提示4周后胰管与空肠黏膜间形成瘢痕愈合,连接紧密.结论 Kissing胰肠吻合简便,易推广,胰管、空肠黏膜间可形成严密瘢痕愈合,未见积液或脓腔等,具有临床应用价值.
목적 통과동물실험탐색Kissing식이장문합적가행성화안전성,명학이관、점막유합적병리과정.방법 통과측정이장문합후문합구내수압,구증해문합적엄밀성；통과문합후불동시간적수술탐사、이장관조영화병이학검사증실문합후이선잔단여공장점막지간유합정황화병리연변과정.결과 소유실험견균순리완성이장문합술,내수압측정균재90 cm H2O이상,각시간단처사적실험견균견문합구긴밀,무출혈、루구,조영견이관여장강련속,충영량호,미견조영제외삼현상.병리절편제시4주후이관여공장점막간형성반흔유합,련접긴밀.결론 Kissing이장문합간편,역추엄,이관、공장점막간가형성엄밀반흔유합,미견적액혹농강등,구유림상응용개치.
Objective To evaluate the feasibility and safety of the modified panceaticojejunostomy called Kissing panceaticojejunostomy by animal experiment,and to explore the pathological process of primary healing between the pancreatic duct and the jejunal mucous.Methods The tolerance pressure at the anastomotic intestine was measured during surgery to ensure close contact suture of Kissing panceaticojejunostomy.Exploratory laparotomy,pancreatic ductography and pathology was performed at 2,4 weeks after panceaticojejunostomy.Results Kissing panceaticojejunostomy was performed successfully on 6 Beagle dogs.Tolerance pressure in all dogs was 90 cm H2O and above.No bleeding、fistula or contrast extravasation was found,and healing anastomosis was identified by laparotomy and pancreatic ductography.Cicatricial healing was found between pancreatic duct and jejunal mucosa 4 weeks after anastomosis.Conclusions Kissing panceaticojejunostomy is easy to perform,ensuring close-up cicatricial healing without hydrops or abscess between pancreatic duct and jejunal mucosa.