摘要
胰十二指肠切除术(PD)是目前治疗胰头肿瘤、胆总管下端癌、壶腹周围以及部分十二指肠肿瘤的主要方法,但PD的并发症发生率和病死率均较高,并且是最复杂的普通外科手术之一,尤其是胰瘘,已成为影响胰肠吻合术后发生患者死亡的独立危险因素。目前,套入式胰肠端端吻合术、胰管对空肠黏膜端侧吻合术、套入式胰肠端侧吻合术、Blumgart吻合术和捆绑式胰肠吻合术等胰肠吻合术式在临床上比较常用,分析各种术式的手术特点及不足之处,可为探索安全、有效的胰肠吻合术,降低胰瘘发生率,促进患者快速康复提供帮助。
Pancreaticoduodenectomy( PD) is currently the main method for the treatment of pancreatic head tumors,lower common bile duct cancer,periampullary and partial duodenal tumors. However,it is one of the most complicated operations in general surgery,with high complication incidence and mortality. The postoperative pancreatic fistula,for example,is especially the main factor to cause death after the operation of pancreaticojejunostomy. At present,the commonly used pancreaticojejunostomy in clinical practice includes: nested pancreaticotocin end-to-end anastomosis,pancreatic duct-to-jejunal mucosal end-to-side anastomosis,in-line end-to-side pancreaticojejunostomy,Blumgart anastomosis and bundled pancreaticojejunostomy. Here studies the features and shortcomings of different approaches,which contributes to safe and effective pancreaticojejunostomy in order to reduce the incidence of pancreatic fistula and promote the fast recovery of the patients.
作者
万涛
郑军
姚汝铖
谭潇
WAN Tao;ZHENG Jun;YAO Rucheng;TAN Xiao(The First College of Clinical Medical Science of China Three Gorges University/Institute of Hepatopancreatobilary Surgery of China Three Gorges University,Yichang 443003,China;College of Medical Science of China Three Gorges University/Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy,Yichang 443002,China)
出处
《医学综述》
2020年第4期678-682,共5页
Medical Recapitulate
基金
国家自然科学基金(81602743)
湖北省自然科学基金面上项目(2016CFB152)。
关键词
胰肠吻合
胰瘘
胰十二指肠切除术
Pancreaticojejunostomy
Postoperative pancreatic fistula
Pancreaticoduodenectomy
