摘要
目的探讨包埋式吻合和间断外翻式吻合两种胰肠吻合方式对腹腔镜胰十二指肠切除术(LPD)后胰瘘发生率的影响。方法回顾性分析2016年3月至2020年3月期间在西安交通大学医学部附属咸阳市中心医院行LPD的116例患者的临床资料。根据实施胰肠吻合的方式分为两组:包埋式吻合组(n=55)和间断外翻式吻合组(n=61)。观察比较两组患者的胰肠吻合、胆肠吻合、胃肠吻合的时长,以及术中出血量、术后并发症发生情况等。结果116例患者中男性67例,女性49例,中位年龄61.5岁。两组患者均无围手术期死亡发生。包埋式吻合组的手术时间、消化道重建时间和胰肠吻合时间分别为(260±20)、(65±15)和(35±15)min,低于间断外翻式吻合组(305±25)、(81±25)和(45±12)min,差异具有统计学意义(P<0.05)。包埋式吻合组的A、B级胰瘘发生率分别为27.3%(15/55)和21.8%(12/55),高于间断外翻式吻合组8.2%(5/61)和6.6%(4/61),差异具有统计学意义(P<0.05)。间断外翻式吻合组的术后住院时间(10.3±1.1)d低于包埋式吻合组(15.2±3.2)d,差异有统计学意义(P<0.05)。结论在LPD中,胰肠吻合应用间断外翻式吻合相较于包埋式吻合可以降低术后胰瘘发生率,缩短术后住院时间。
Objective To compare the embedding anastomosis with the intermittent eversion anastomosis on the pancreatic fistula rates after laparoscopic pancreaticoduodenectomy(LPD).Methods The clinical data of 116 patients who underwent LPD at the Center Hospital of Xianyang City affiliated to Xi'an Jiaotong University Health Science Center from March 2016 to March 2020 were retrospectively studied.According to the method of pancreaticojejunostomy used,these patients were divided into the following two groups:the embedding anastomosis group(n=55)and the intermittent eversion anastomosis group(n=61).The duration of pancreaticojejunostomy,bilioenterostomy and gastrointestinal anastomoses,and the amounts of intraoperative blood loss and postoperative complication rates were compared between the two groups.Results Of 116 patients in this study,there were 67 males and 49 females,with a median age of 61.5 years.No perioperative death occurred in the 2 groups.The operation time,digestive tract reconstruction time and pancreaticojejunostomy time in the embedded anastomosis group were(260±20),(65±15)and(35±15)min,respectively,which were significantly lower than those in the intermittent eversion anastomosis group(305±25),(81±25)and(45±12)min,(all P<0.05).The grade A and B pancreatic fistula rates in the embedded anastomosis group were 27.3%(15/55)and 21.8%(12/55),respectively,which were significantly higher than those in the intermittent eversion anastomosis group[8.2%(5/61)and 6.6%(4/61)],(all P<0.05).The postoperative hospital stay in the intermittent eversion anastomosis group(10.3±1.1)d was significantly lower than that in the embedding anastomosis group[(15.2±3.2)d,P<0.05].Conclusion In LPD,when compared with embedded pancreaticojejunostomy,intermittent eversion pancreaticojejunostomy reduced the postoperative pancreatic fistula rate and shortened the postoperative hospital stay.
作者
张成
安东均
王羊
杨林
王金涛
韩立
赵宝国
徐垚
韩博强
Zhang Cheng;An Dongjun;Wang Yang;Yang Lin;Wang Jintao;Han Li;Zhao Baoguo;Xu Yao;Han Boqiang(Department of Hepatobiliary Surgery,the Center Hospital of Xianyang City,Xi'an Jiaotong University Health Science Center,Xianyang 712000,China)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2021年第8期610-613,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
胰十二指肠切除术
腹腔镜检查
胰腺瘘
胰肠吻合
Pancreaticoduodenectomy
Laparoscopy
Pancreatic fistula
Pancreatojejunostomy
