摘要
目的探讨胰管捆绑外引流在腹腔镜胰十二指肠切除术中的应用效果。方法回顾性分析2017年1月至2019年10月由河北医科大学第二医院肝胆外科同一治疗组行腹腔镜胰十二指肠切除术的21例患者的资料。所有患者术中均采用胰管捆绑外引流的胰肠吻合方式。男性12例,女性9例,年龄(63.1±8.1)岁(范围:46~77岁),体重指数(24.8±3.2)kg/m^2(范围:18.8~29.1?kg/m^2)。合并高血压病3例,糖尿病5例,同时合并高血压病和糖尿病3例,合并乙肝肝硬化3例。结果本组中21例患者均顺利完成腹腔镜胰十二指肠切除术,胰肠吻合方式均为胰管捆绑外引流式。手术时间(359.3±71.0)min,胰肠吻合时间(23.8±7.4)min,胰管直径(3.3±0.6)mm,术中出血量(247.6±90.1)ml,术后住院时间(13.7±4.9)d。术后出现B级胰瘘1例,未发生C级胰瘘,胰瘘发生率4.8%,术后发生胆瘘3例,切口感染1例,胃排空延迟2例,腹腔积液1例,无死亡及二次手术病例。结论胰管捆绑外引流的胰肠吻合方式简单、易操作,用于具有胰瘘高危因素的腹腔镜胰十二指肠切除术的患者,可减少术后胰瘘及相关并发症。
Objective To examine the effect of pancreaticojejunostomy with pancreatic duct binding external drainage in laparoscopic pancreatoduodenectomy.Methods The data of 21 patients who underwent laparoscopic pancreaticoduodenectomy in the same treatment group from January 2017 to October 2019 in Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University were analyzed retrospectively.All patients underwent pancreaticojejunostomy with external drainage of pancreatic ducts.There were 12 males and 9 females,aged(63.1±8.1)years old(range:46 to 77 years old),body mass index(24.8±3.2)kg/m2(range:18.8 to 29.1 kg/m2).There were 3 cases of hypertension,5 cases of diabetes,3 cases of hypertension and diabetes,3 cases of liver cirrhosis.Results Laparoscopic pancreatoduodenectomy was successfully performed in all 21 patients.The operation time was(359.3±71.0)minutes,the pancreaticojejunostomy time was(23.8±7.4)minutes,the diameter of pancreatic duct was(3.3±0.6)mm,the intraoperative blood loss was(247.6±90.1)ml,the postoperative hospital stay was(13.7±4.9)days,the leakage of B-level fistula occurred in 1 case(4.8%),and there was no C-level pancreatic fistula.There were 3 cases of bile leakage,1 case of incision infection,2 cases of gastroparesis,1 case of hydrops abdominis,no death and secondary operation.Conclusion It is a simple and easy method of pancreatoenterostomy with pancreatic duct binding external drainage,which can reduce the incidence of pancreatic fistula and related complications after laparoscopic pancreatoduodenectomy for patients with high risk pancreatic fistula.
作者
陈圣雄
赵伟红
周泽高
段佳悦
徐晨
闫长青
Chen Shengxiong;Zhao Weihong;Zhou Zegao;Duan Jiayue;Xu Chen;Yan Changqing(Department of Hepatobiliary Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)
出处
《中华外科杂志》
CAS
CSCD
北大核心
2020年第7期516-519,共4页
Chinese Journal of Surgery
关键词
胰十二指肠切除术
腹腔镜
胰管捆绑
外引流
胰肠吻合
Pancreatoduodenectomy
Laparoscopy
Pancreatic duct binding
External drainage
Pancreatoenterostomy
