CAJ | 학술논문

目的：探讨不同吻合术式在胰十二指肠切除术中的临床效果。方法选取67例行胰十二指肠切除术患者作为研究对象,根据术式不同分为套入式胰肠端侧吻合组(22例)、捆绑式胰肠端端吻合组(21例)及捆绑式胰胃吻合组(24例),比较3组患者的平均手术时间、术中出血量、住院时间、术后腹腔引流液淀粉酶水平及术后胰瘘发生率。结果套入式胰腺端侧吻合组、捆绑式胰肠端端吻合组及捆绑式胰胃吻合组平均手术时间分别为(3.68±0.42)h、(4.02±0.56)h、(4.56±0.72)h,术中出血量分别为(421.67±20.21)ml、(465.84±23.56)ml、(485.56±27.46)ml,住院天数分别为(22.36±2.36)d、(21.46±3.21)d、(20.35±2.27)d,术后第1天腹腔引流液淀粉酶水平分别为(50.32±0.87)IU/L、(45.65±0.79) IU/L、(42.75±0.65) IU/L,术后第7天腹腔引流液淀粉酶水平分别为(8.21±0.32) IU/L、(7.01±0.25) IU/L、(6.89±0.21) IU/L,胰瘘发生率分别为9.1%(2/22),9.5%(2/21)和12.5%(3/24),3组上述指标比较差异均无统计学意义( P >0.05)。结论对于行胰十二指肠切除术的患者,不同胰腺残端吻合方式临床效果及术后胰瘘发生率相似。
목적：탐토불동문합술식재이십이지장절제술중적림상효과。방법선취67례행이십이지장절제술환자작위연구대상,근거술식불동분위투입식이장단측문합조(22례)、곤방식이장단단문합조(21례)급곤방식이위문합조(24례),비교3조환자적평균수술시간、술중출혈량、주원시간、술후복강인류액정분매수평급술후이루발생솔。결과투입식이선단측문합조、곤방식이장단단문합조급곤방식이위문합조평균수술시간분별위(3.68±0.42)h、(4.02±0.56)h、(4.56±0.72)h,술중출혈량분별위(421.67±20.21)ml、(465.84±23.56)ml、(485.56±27.46)ml,주원천수분별위(22.36±2.36)d、(21.46±3.21)d、(20.35±2.27)d,술후제1천복강인류액정분매수평분별위(50.32±0.87)IU/L、(45.65±0.79) IU/L、(42.75±0.65) IU/L,술후제7천복강인류액정분매수평분별위(8.21±0.32) IU/L、(7.01±0.25) IU/L、(6.89±0.21) IU/L,이루발생솔분별위9.1%(2/22),9.5%(2/21)화12.5%(3/24),3조상술지표비교차이균무통계학의의( P >0.05)。결론대우행이십이지장절제술적환자,불동이선잔단문합방식림상효과급술후이루발생솔상사。
Objective To investigate the clinical effect of different anastomosis in pancreaticoduodenectomy. Met-hods 67 cases of pancreatoduodenectomy were selected as the research object, according to the different surgical methods, they were divided into the set in the pancreas intestines end to side anastomosis group (22 cases), bundled pancreatic end-to-end anastomosis group (21 cases) and bundled pancreas stomach anastomosis group (24 cases), compare the 3 groups’ aver-age operative time, amount of bleeding, hospitalization time, postoperative peritoneal fluid amylase level and postoperative pancreatic fistula rate. Results Set in the pancreas intestines end to side anastomosis group, bundled pancreatic end-to-end anastomosis group and bundled pancreas stomach anastomosis group’s mean operative time was (3. 68 ± 0. 42) h, (4. 02 ± 0. 56)h, (4. 56 ± 0. 72) h, blood loss were (421. 67 ± 20. 21) ml, (465. 84 ± 23. 56) ml, (485. 56 ± 27. 46) ml, respec-tively, the number of days of hospitalization were (22. 36 ± 2. 36) d, (21. 46 ± 3. 21) d, (20. 35 ± 2. 27) d, the first day af-ter peritoneal drainage fluid amylase levels were (50. 32 ± 0. 87) IU/L, (45. 65 ± 0. 79) IU/L, (42. 75 ± 0. 65) IU/L, the seven days after surgery peritoneal drainage fluid amylase levels were (8. 21 ± 0. 32) IU/L, (7. 01 ± 0. 25) IU/L,(6. 89 ± 0. 21)IU/L, the incidence of pancreatic fistula were 9. 1% (2/22), 9. 5% (2/21) and 12. 5% (3/24), the index differ-ence between the three groups were not statistically significant ( P >0. 05). Conclusion For patients received pancreati-coduodenectomy, different pancreatic anastomosis’ s clinical effects and the incidence of postoperative pancreatic fistula were similar.