改良胆肠内支撑外引流在胰十二指肠切除术中细口径胆肠吻合中的应用

发布时间：2018-03-07 05:28

本文选题：胆肠吻合术　切入点：T管支撑引流　出处：《中国实用外科杂志》2017年02期 　论文类型：期刊论文

【摘要】：目的探讨胰十二指肠切除术中细口径胆肠吻合使用改良的T管支撑引流的安全性和有效性。方法回顾性分析2009年8月至2014年8月第二军医大学附属长海医院胰腺外科行胰十二指肠切除术的胆管直径8 mm、胰管直径正常的166例病人资料,其中81例病人采用改良的T管支撑引流胆肠吻合(改良组),85例病人采用直接胆肠吻合(常规组),比较分析两组胆瘘、胰瘘发生率及其他手术相关指标的差异。结果改良组病人在术后胰瘘、胆瘘的发生率,术中出血量及住院时间,术后胆肠吻合口狭窄发生率均低于常规组(P均0.05)。结论改良的T管支撑引流胆肠吻合操作简便,在降低胰瘘、胆瘘发生率方面有优势,同时存在术中出血少,住院时间短及术后胆肠吻合口狭窄发生率低等优点,是胰十二指肠切除术中胆肠吻合的一种有效的改良方案,值得临床推广应用。
[Abstract]:Objective to investigate the safety and efficacy of modified T-tube support drainage in pancreaticoduodenectomy with small caliber choledochojejunostomy. Methods from August 2009 to August 2014, the pancreas of Changhai Hospital affiliated to the second military Medical University was retrospectively analyzed. The diameter of bile duct was 8 mm and the diameter of pancreatic duct was normal in 166 patients who underwent pancreaticoduodenectomy. Among them, 81 patients were treated with modified T-tube drainage and cholangiojejunostomy. 85 patients in the modified group were treated with direct choledochojejunostomy. Results the incidence of pancreatic fistula, biliary fistula, intraoperative bleeding and hospital stay were significantly different in the modified group. The incidence of biliary anastomotic stenosis after operation was lower than that in the routine group (P < 0.05). Conclusion the modified T-tube supported drainage choledochojejunostomy is easy to operate and has advantages in reducing the incidence of pancreatic fistula and biliary fistula, at the same time, there is less bleeding during operation. The advantages of short hospital stay and low incidence of cholangiojejunostomy stenosis are an effective and improved method for cholangiojejunostomy in pancreaticoduodenectomy.
【作者单位】：第二军医大学附属长海医院胰腺外科;
【基金】：上海市自然科学基金(No.14ZR1408700)
【分类号】：R656

【参考文献】