CAJ | 학술논문

目的比较胰十二指肠切除术中运用胰肠吻合与双荷包胰胃吻合的近期疗效,探讨胰肠吻合和双荷包胰胃吻合在胰十二指肠切除术中的合理性选择.方法回顾性该院2010年1月至2012年12月间38例行胰十二指肠切除术患者的临床资料.其中采用胰肠吻合12例,双荷包胰胃吻合26例.结果 38例患者手术均顺利完成.双荷包胰胃吻合组胰瘘发生率(0％)、手术时间[(327.50±32.56) min]、术后住院天数[(10.31±2.44) d]显著少于胰肠吻合组[分别为3/12、(425.83±33.77) min和(14.33±4.14)d],差异有统计学意义(P＜0.05).胆漏、术后腹腔出血、胃排空延迟、切口感染、肺部感染发生率以及术中出血量虽然亦低于胰肠吻合组,但差异无统计学意义.结论双荷包胰胃吻合是较胰肠吻合相对安全合理的消化道重建方式.前者操作简便,手术时间短,在近期疗效上对预防术后胰瘘等并发症具有很大优越性.
목적 비교이십이지장절제술중운용이장문합여쌍하포이위문합적근기료효,탐토이장문합화쌍하포이위문합재이십이지장절제술중적합이성선택.방법 회고성해원2010년1월지2012년12월간38례행이십이지장절제술환자적림상자료.기중채용이장문합12례,쌍하포이위문합26례.결과 38례환자수술균순리완성.쌍하포이위문합조이루발생솔(0％)、수술시간[(327.50±32.56) min]、술후주원천수[(10.31±2.44) d]현저소우이장문합조[분별위3/12、(425.83±33.77) min화(14.33±4.14)d],차이유통계학의의(P＜0.05).담루、술후복강출혈、위배공연지、절구감염、폐부감염발생솔이급술중출혈량수연역저우이장문합조,단차이무통계학의의.결론 쌍하포이위문합시교이장문합상대안전합리적소화도중건방식.전자조작간편,수술시간단,재근기료효상대예방술후이루등병발증구유흔대우월성.
Objective To explore the rationality of pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy through comparing the short-term effects between pancreaticojejunostomy and double purse embedded pancreaticogastrostomy in pancreaticoduodenectomy.Methods A retrospective review was performed for 38 patients who were underwent pancreaticoduodenectomy at the second affiliated hospital of Kunming Medical University from January 2010 to December 2012.Results All 38 pancreaticoduodenectomy were performed successfully.The pancreatic fistula (0％),operationtime [(327.50±32.56) min],postoperative hospital days [(10.31 ±2.44) d] were found to be significantly lower in double purse embedded pancreaticogastrostomy group than those of pancreaticojejunostomy group [3/12,(425.83 ± 33.77) min,(14.33 ± 4.14) d],which has statistical significance(P＜0.05).Although the incidence of bile leakage,postoperative abdominal bleeding,delayed gastric emptying,infection of incision,infection of lung,intraoperative amount of bleeding are also lower than that of pancreaticojejunostomy group,which has no statistical significance.Conclusions Double purse embedded pancreaticogastrostomy is a digestive tract reconstruction which is safer and more reasonable than pancreaticojejunostomy.The former one is operated simply and the operation time is shorter.There are great advantages in the prevention of complications such as pancreatic fistula after pancreaticoduodenectomy.