胰腺-空肠端端套入式间断U型缝合法吻合在胰腺外科中的应用

目的:探讨胰腺-空肠端端套入式间断U型缝合法吻合在胰腺外科应用的临床价值。方法:回顾性分析我院自2001年1月到2006年4月间施行的胰头十二指肠切除术83例。比较不同胰肠吻合方法对胰瘘发生的影响。结果:胰瘘总发生率为27%(22/83)。胰肠端端套入式间断U型缝合法吻合术后恢复良好,无胰瘘发生。端端吻合的胰瘘发生率为40%(10/25);端侧吻合的胰瘘发生率为27%(12/44)。比较各种吻合方式,端端套入式间断U型缝合法吻合的胰瘘发生率显著低于端端吻合(P<0.01)和端侧吻合(P<0.05),而端端吻合和端侧吻合之间胰瘘发生率无明显差异(P>0.05)。结论:胰腺-空肠端端套入式间断U型缝合法吻合降低手术所致胰肠吻合口瘘的发生率,效果满意。但因临床例数较少,其安全可靠性、实用合理性还有待进一步观察、证实。

Effect of end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture in pancreatic surgery

Objective To summarize the ways of pancreaticoenteric anastomose in the pancreatic operation.To study the safety and feasibility of a new operative procedure called end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture used to prevent anastomotics leakage following pancreaticojejunostomy(PJ).Method Eighty-three patients receiving pancreaticoduodenectomy in our hospital between 2001 January and 2006 April were reviewed.Results The overall incidence of pancreatic leakage was 27%.The leakage rate following end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture was significantly lower than those of end-to-end anastomosis(P<0.01) and those of end-to-side anastomosis(P<0.05),but there was no significant difference between end-to-end anastomosis and end-to-side anastomosis(P>0.05).Conclusion The procedure has a definite effect to avoid anastomotics leakage following pancreaticojejunostomy and would be worthy of being recommended.But because the cases were so lack,the procedure would need be approved more in the future.