CAJ | 학술논문

目的介绍一种新的可吸收补片加固胰胃吻合方法.方法回顾性分析浙江大学医学院附属邵逸夫医院2011年5月至2013年1月23例采用可吸收生物补片加固胰胃吻合术患者的临床资料.采用一种可吸收补片加固胰胃吻合术,将可吸收补片“戴戒式”固定于胰腺残端从而加固胰胃吻合口.术中测定胰胃吻合时间及吻合口压力;术后监测腹腔引流液量及引流液淀粉酶值,观察有无术后腹腔感染、出血等并发症发生.结果 23例患者胰胃吻合耗时20～ 35 min,平均24 min.术中吻合口测压25 cm H2O(1 cm H2O =0.098 kPa)时无一例渗漏.根据胰漏分级,术后发生A级胰漏6例(26.1％),B级1例(4.3％),C级0例.发生腹腔感染1例,无术后腹腔内出血、胆漏、胃肠吻合口瘘等并发症发生.结论可吸收补片加固胰胃吻合术作为一种新的吻合方法,操作简单,安全可靠.该方法适用于任何质地的胰腺,特别适用于质地柔软的胰腺行胰腺消化道重建.
목적 개소일충신적가흡수보편가고이위문합방법.방법 회고성분석절강대학의학원부속소일부의원2011년5월지2013년1월23례채용가흡수생물보편가고이위문합술환자적림상자료.채용일충가흡수보편가고이위문합술,장가흡수보편“대계식”고정우이선잔단종이가고이위문합구.술중측정이위문합시간급문합구압력;술후감측복강인류액량급인류액정분매치,관찰유무술후복강감염、출혈등병발증발생.결과 23례환자이위문합모시20～ 35 min,평균24 min.술중문합구측압25 cm H2O(1 cm H2O =0.098 kPa)시무일례삼루.근거이루분급,술후발생A급이루6례(26.1％),B급1례(4.3％),C급0례.발생복강감염1례,무술후복강내출혈、담루、위장문합구루등병발증발생.결론 가흡수보편가고이위문합술작위일충신적문합방법,조작간단,안전가고.해방법괄용우임하질지적이선,특별괄용우질지유연적이선행이선소화도중건.
Objective To evaluate the clinical efficacy of bio-mesh-reinforced pancreatogastrostomy.Methods A total of 23 patients undergoing bio-mesh-reinforced pancreatogastrostomy from May 2011 to January 2013 were retrospectively analyzed.Their demographic data,operative parameters and post-operative outcomes were recorded.The severity of pancreatic leak was determined according to the criteria of International Study Group on Pancreatic Fistula (ISGPF).Results The mean anastomotic time was 24 (20-35) minutes.Intra-operative leak tests showed all pancreatic anastomoses were watertight.Six patients (26.1％) had pancreatic leakage of grade A.One patient (4.3％) had pancreatic leakage of grade B.No patient developed postoperative pancreatic leakage of class C.One case of abdominal infection was reported.No severe complications such as hemorrhage,bile leakage or gastrojejunostomy leakage were observed.All patients recovered well within Month 1 post-discharge.Conclusion This novel technique may be a simple and feasible strategy for all types of pancreatic remnants.