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胰十二指肠切除术中胰肠吻合口的重建
引用本文:李江涛,彭淑牖.胰十二指肠切除术中胰肠吻合口的重建[J].中华胃肠外科杂志,2014(5):427-430.
作者姓名:李江涛  彭淑牖
作者单位:浙江大学医学院附属第二医院外科,杭州310009
摘    要:胰肠吻合口的重建是胰十二指肠切除术中重要的组成步骤,也是影响其成败的关键。根据重建方式的不同,主要分为胰腺-空肠吻合和胰胃吻合。根据胰腺残端与空肠吻合位置的不同,分为端端吻合和端侧吻合。在目前的随机对照研究中,胰腺-空肠吻合和胰胃吻合在胰漏的发生率方面无明显的差异。捆绑式胰肠和捆绑式胰胃吻合分别建立在经典胰肠(胃)吻合的基础上,操作简便,预防胰肠吻合口瘘效果确切。胰肠吻合口成功与否的影响因素包括胰腺质地和胰管大小等,胰管支撑管的放置可能有助于减少胰肠吻合口瘘的发生。胰十二指肠切除术中的消化道重建,应遵循简单、有效的原则,才能将胰肠吻合口瘘的发生减至最低。

关 键 词:胰十二指肠切除术  胰肠吻合  胰漏

Reconstruction of pancreaticoenteric anastomosis after pancreaticoduodenectomy
Li Jiangtao,Peng Shuyou.Reconstruction of pancreaticoenteric anastomosis after pancreaticoduodenectomy[J].Chinese Journal of Gastrointestinal Surgery,2014(5):427-430.
Authors:Li Jiangtao  Peng Shuyou
Affiliation:Department of Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
Abstract:Pancreaticoenteric anastomosis is an important step during pancreaticoduodenectomy. Based on the anastomosis site, pancreaticoenteric anastomosis is classified as pancreaticojejunostomy anastomosis and pancreaticogastr-ostomy. Depending on the jejunum site, reconstruction can be perform as end-to-end or end-to-side anastomosis. Previous randomized clinical trials, showed no significant differences between pancreaticojejunostomy and pancreaticogastrostomy. Binding pancreaticojejunostomy and binding pancreaticogastr-ostomy are easy to perform. The rate of pancreatic leakage is related to the texture of the pancreas and the size of the pancreatic duct. It is helpful to reduce pancreatic leakage by placing a pancreatic duct stent. The simple and effective pancreaticoenteric reconstruction is the future direction for minimizing leakage.
Keywords:Pancreaticoduodenectomy  Pancreatico-enteric anastomosis  Pancreatic leakage
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