摘要
目的:探讨小口径吻合器胆肠吻合在合并胆总管扩张壶腹部肿瘤胰十二指肠切除术中的应用。方法:2007年5月～2009年10月共30例伴胆总管扩张壶腹部肿瘤患者接受胰十二指肠切除术,其中16例行小口径吻合器胆肠吻合,其余14例采用常规方法吻合,分析其临床资料和病理结果,比较两组手术前后血清电解质、肝功能变化,手术时间,两组吻合口大小、吻合时间、吻合口狭窄发生率及胆道感染情况,手术后进食时间、住院时间和并发症发生情况。结果:全组无手术死亡及严重并发症发生。与常规术式组相比,观察组的胆肠吻合手术时间短,P=0.036,术后进食时间早,术后住院时间短,P=0.047,术后3个月胆管直径、胆漏发生率、吻合口狭窄发生率相当,两组间手术前后血钠、血钾、肝功能变化差异无统计学意义(P>0.05)。结论:有胆管扩张的患者以小口径吻合器胆肠吻合同时不放置T管是安全可行的。
Objective：To discuss the validity of choledochojejunostomy performed with mechanical stapler in pancreaticoduodenectomy. Methods：30 patients with cancer of pancreatic head, periampullary adenocarcinoma companied with biliary obstruction underwent pancreaticoduodenectomy in which choledochojejunostomy was done with stapler without T tube drainage in 16 cases. The other patients underwent operation with routine way. Results：All cases were evaluated perioperatively period and followed up. The choledochojejunostomy was finished quickly in observed group than contrast group, and had early time for eat and less hospital stay. The complication was no more than contrast group. No biliary fistula and pancreatic fistula occurred. A good demonstration of both biliary tract and bilio-digestive anastomosis was obtained by follow-up with B ultrosound scan and no jaundice was found. Conclusion：Stapler device can be used in choledochojejunostomy safely if a common biliary tract is dilate enough large.
出处
《中国当代医药》
2011年第15期5-7,共3页
China Modern Medicine
关键词
胆肠吻合
胆管
吻合器
胰十二指肠切除术
胰瘘
胆瘘
Choledochojejunostomy
Bile duct
Stapler
Pancreaticoduodenectomy
Pancreatic fistula
Biliary fistula
