目的探讨如何降低胰十二指肠切除术后胰空肠吻合口漏的发生。
方法采用胰管空肠吻合胰腺残端套入法行胰肠吻合,按胰、胆、胃顺序与空肠重建消化道。
结果27例胰十二指肠切除术中,手术并发症7例(25.93%),其中应激性溃疡出血3例,胃排空延迟2例,腹腔及腹壁创口感染各1例,均经非手术治愈。全组无围手术期死亡,亦无一例发生胰瘘。
结论胰瘘的发生同术式和操作技术密切相关,亦与吻合口部位血供和张力以及吻合口远端通畅与否有关。本术式增加了胰空肠吻合的严密性,对预防胰瘘的发生起到了积极的效果,且操作简便,易于掌握,效果可靠。
Citation:
王秉成,徐元灯,朱小勇. Prevention Pancreatic Fistula after Whipple Operation by Casing Stump Ends of Pancreas and PancreaticojejunostomyReport of Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(4): 448-450. doi:
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王秉成, 向家庆, 胡文科. 胰管空肠吻合胰腺残端套入法预防Whipple术后胰瘘(附17例报告) [J]. 中华肝胆外科杂志, 1999; 5(4)∶257.
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- 1. 黄莚庭主编. 腹部外科手术并发症 [M]. 第1版 . 北京: 人民卫生出版社, 2000∶556~558.
- 2. Gulbinas A, Barauskas G, Pundzius J, et al. The impact of morphologic and physiologic peculiarities of the pancreas on pancreasrelated complications following pancreatoduodenectomy [J]. Medicina (Kaunas), 2003; 39(2)∶151.
- 3. Poon RT, Lo SH, Fong D, et al. Prevention of pancreatic anastomotic leakage after pancreaticoduodenectomy [J]. Am J Surg, 2002; 183(1)∶42.
- 4. 叶云奎. 胰头十二指肠切除并发症的防治体会 [J]. 肝胆胰外科杂志, 1996; 8(2)∶72.
- 5. 王志军, 吴阳, 彭启平, 等. 胰十二指肠切除术后发生胰瘘的危险因素 [J]. 中国普外基础与临床杂志, 2005; 12(4)∶403.
- 6. 王秉成, 向家庆, 胡文科. 胰管空肠吻合胰腺残端套入法预防Whipple术后胰瘘(附17例报告) [J]. 中华肝胆外科杂志, 1999; 5(4)∶257.