CAJ | 학술논문

目的分析胰十二指肠切除端端套入式胰肠吻合术后胰管流出道狭窄发生情况及危险因素.方法前瞻性收集35例胰十二指肠切除术患者的临床病例资料,其中7例出现胰管流出道狭窄.依据增强CT测定胰管的直径;规定胰管直径差为术后胰管直径减术前胰管直径,胰管直径差＞1.0mm为胰管流出道狭窄;按有无胰管流出道狭窄分为两组. 结果本组患者术前胰管直径(4.2±2.4) mm(1.0～10.0 mm),胰管直径＜3.0 mm的15例.单因素分析示总胆红素(P =0.028)、碱性磷酸酶(P =0.036)、术前胰管直径(P=0.007)在两组之间差异有统计学意义,多元线性回归分析示术前胰管直径是胰管直径差的独立危险因素(P＜0.001),相关性分析示术前胰管直径与胰管直径差呈线性负相关.结论胰十二指肠切除端端套入式胰肠吻合术后胰管流出道狭窄发生率不低,术前胰管直径是独立危险因素.
목적 분석이십이지장절제단단투입식이장문합술후이관류출도협착발생정황급위험인소.방법 전첨성수집35례이십이지장절제술환자적림상병례자료,기중7례출현이관류출도협착.의거증강CT측정이관적직경;규정이관직경차위술후이관직경감술전이관직경,이관직경차＞1.0mm위이관류출도협착;안유무이관류출도협착분위량조. 결과 본조환자술전이관직경(4.2±2.4) mm(1.0～10.0 mm),이관직경＜3.0 mm적15례.단인소분석시총담홍소(P =0.028)、감성린산매(P =0.036)、술전이관직경(P=0.007)재량조지간차이유통계학의의,다원선성회귀분석시술전이관직경시이관직경차적독립위험인소(P＜0.001),상관성분석시술전이관직경여이관직경차정선성부상관.결론 이십이지장절제단단투입식이장문합술후이관류출도협착발생솔불저,술전이관직경시독립위험인소.
Objective To Analyze the prevalence and risk factors of outflow tract strictures of the pancreatic duct after pancreatiocoduodenectomy using end-to-end invagination pancreaticojejunostomy.Methods The clinical data of 35 patients undergoing pancreatiocoduodenectomy was prospectively collected and analyzed.Among them 7 cases suffered from outflow tract strictures of the pancreatic duct.The diameter of the pancreatic duct was measured by enhanced CT.The postoperative pancreatic duct diameter reduction greater than 1.0 mm is termed as outflow tract stricture of the pancreatic duct.The two groups with or without outflow tract strictures were compared.Results The pancreatic duct diameter before operation was (4.2 ± 2.4) mm(1.0-10.0mm),15 cases of them were less than 3.0 mm.Total bilirubin (P =0.028),alkaline phospatase (P =0.036) and preoperative pancreatic duct (P =0.007) demonstrated statistically significant differences between cases of outflow tract strictures and those without strictures.Multivariable linear regression return analysis shows that preoperative pancreatic duct diameter is the independent risk factor for pancreatic duct diameter variation after pancreaticojejunostomy (P ＜ 0.001).Furthermore,correlation analysis exhibited a linear negative correlation between preoperative pancreatic duct diameter and the pancreatic duct diameter variation.Conclusions Outflow tract stricture of the pancreatic duct is not rare after pancreatiocoduodenectomy using end-to-end invagination pancreaticojejunostomy,preoperative pancreatic duct diameter is an independent risk factor.