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[1]许朱定,张海斌,沈 翔,等.胰十二指肠切除术198例疗效分析[J].医学研究与战创伤救治(原医学研究生学报),2013,15(05):436-438.[doi:10.3969/j.issn.1672-271X.2013.05.002]
　XU Zhu-ding,ZHANG Hai-bin,SHEN Xiang,et al.Application of the placement of pancreatic duct sents and external drainage in pancreatoduodenectomy:an analysis of 198 cases[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2013,15(05):436-438.[doi:10.3969/j.issn.1672-271X.2013.05.002]
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胰十二指肠切除术198例疗效分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第15卷
期数:
2013年05期
页码:
436-438
栏目:
出版日期:
2013-10-20

文章信息/Info

Title:
Application of the placement of pancreatic duct sents and external drainage in pancreatoduodenectomy:an analysis of 198 cases
作者:
许朱定1; 2; 张海斌2; 沈 翔1; 杨 宁2; 付 雍2; 杨广顺2
1.212001江苏镇江，解放军359医院外科；2.200438上海，第二军医大学东方肝胆外科医院肝外五科
Author(s):
XU Zhu-ding1; 2; ZHANG Hai-bin2; SHEN Xiang1; YANG Ning2; FU Yong2; YANG Guang-shun2
1.Department of Surgery，359 Hospital of PLA，Zhenjiang，Jiangsu 212001，China; 2.5th Department of Liver Surgery，Eastern Hepatobilary Surgery Hospital，the Second Military Medical University，Shanghai 200438，China
关键词:
胰十二指肠切除术; 胰肠吻合; 胰管外引流; 胰漏
Keywords:
pancreaticoduo denectomy;  pancreaticojejunostomy;  pancreatic duct sent drainage;  pancreatic leakage
分类号:
R656.64
DOI:
10.3969/j.issn.1672-271X.2013.05.002
文献标志码:
A
摘要:
目的 总结分析198例胰十二指肠切除术（pancreaticoduo denectomy,PD）临床治疗效果，以期减少术后胰漏（postoperative pancreatic fistula,POPF）的发生。方法 回顾性分析2003年4月-2013年3月完成的198例PD的临床资料。全组病例均采用Child方式重建消化道，胰肠吻合采用胰腺残端空肠两层对端吻合，胰管内置支撑引流管外引流。结果 全组无手术死亡，术中有3例通过手术放大镜寻见胰管，1例胰管未找见而采用胰腺残端结扎；全组无胰漏发生，有4例胃排空障碍；胰腺残端结扎病例出现胰腺炎、胃排空障碍，经生长抑素、胃肠减压及营养支持等治疗后痊愈。结论 术中尽量寻找胰管断端，内置引流管并引出体外，避免了胰酶激活对吻合口的腐蚀，是避免术后胰漏的关键所在。
Abstract:
Objective To Investigate the clinical effect of 198 cases of pancreaticoduodenectomy (PD),in order to decrease incidence of pancreatic leakage.Methods The clinical data of 198 cases of PD admitted between April 2003 to March 2013 at the Second Military Medical University was analyzed retrospectively.All patients used the way of Child to reconstruction; Pancreaticojejunostomy(PJ) used remnant pancreatico-jejunum end-to-end anastomosis; pancreatic duct were used the placement of pancreatic duct sents and drainage external.Results No death and no pancreatic leakage ocurred.Panceatic duct was found by magnifier in 3 cases and not found in 1 case,which followed by suture and ligature the pancreatic remnant.Gastroparesis was found in 4 cases,treated by nasogastric suction,total parenteral nutrition(TPN);and the patient with pancreatis treated with somatostatin analogues and TPN.Conclusion The the placement of pancreatic duct sents and external drainage are the key measure to prevent the pancreatic leakage in PD.

参考文献/References:

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[1１］许朱定，岳树强，沈 翔，等.肠腔减压预防胰十二指肠切除术胰漏的作用［J］.东南国防医药，2007，9(5):332-333.
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[13］陈 曦，周存才,张长和，等.胰肠一层吻合加桥袢内置引流管在预防胰漏中的作用［J］.中华外科杂志，2011,49(6):567-568.

相似文献/References:

[1]曾 丽,曾 彬.胰胃吻合术与胰肠吻合术临床疗效的比较[J].医学研究与战创伤救治(原医学研究生学报),2016,18(01):59.[doi:10.3969/j.issn.1672-271X.2016.01.018]
　ZENG Li,ZENG Bin..The comparison of application value between pancreatic anastomosis and pancreaticojejunostomy in pancreatic resection[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2016,18(05):59.[doi:10.3969/j.issn.1672-271X.2016.01.018]

备注/Memo

备注/Memo:
上海市科委医学引导基金（10411963200）
更新日期/Last Update: 2013-09-20