胰十二指肠切除术中放置与不放置胰管支撑管的比较

发布时间：2018-07-08 13:13

本文选题：胰十二指肠切除术 + 胰管支撑管　；参考：《重庆医科大学》2017年硕士论文

【摘要】：研究背景胰十二指肠切除术是腹部外科最复杂、风险最高的手术之一,术后并发症发生率高,其中胰瘘是最常见和最严重的术后并发症。对于在胰肠吻合的过程中,在胰管内置入支撑管将胰液外引流是否能减少胰瘘的发生率,目前国内外存在广泛的争议,相关的随机对照试验研究也较少。目的评价不同胰肠吻合方式在胰十二指肠切除术中的临床疗效,探讨不放置胰管支撑管的胰肠吻合的适用性。方法我院自2012年1月至2015年12月收治的87例可行胰十二指肠切除术患者,按随机分配方式分为胰管-空肠黏膜对黏膜端侧吻合+胰管支撑管外引流组(A组,43例)和胰腺-空肠端侧吻合不放置胰管支撑管组(B组,44例),比较两种不同胰肠吻合方式行胰肠吻合术的时间及术后住院时间、术后并发症的发生率。结果术中未放入胰管支撑管组的胰肠吻合时间(平均15.4min)明显小于术中放入胰管支撑管组(平均21.1min),差异有统计学意义(t=7.137,P0.05)。B组患者术后住院时间小于A组(t=2.408,P0.05,差异有统计学意义)。两组患者术后胰瘘、腹腔出血、腹腔感染、胃潴留,差异无统计学意义(χ2=0.181,0.322,0.603,0.001;P0.05)。结论胰十二指肠切除术不放置胰管支撑管可减少手术时间,降低术后住院天数,且术后并发症的发生率无显著差异,是安全可靠的。
[Abstract]:Background pancreaticoduodenectomy is one of the most complex and high-risk operations in abdominal surgery. The incidence of postoperative complications is high. Pancreatic fistula is the most common and severe postoperative complication. In the process of pancreaticojejunostomy, whether the drainage of pancreatic juice can reduce the incidence of pancreatic fistula by inserting a supporting tube into the pancreatic duct is widely disputed at home and abroad, and there are few related randomized controlled trials at home and abroad. Objective to evaluate the clinical effect of different pancreaticojejunostomy in pancreaticoduodenectomy and to explore the applicability of pancreaticojejunostomy without pancreatic duct supporting tube. Methods from January 2012 to December 2015, 87 cases of feasible pancreaticoduodenectomy were treated in our hospital. According to the random distribution pattern, the pancreatic duct and jejunum mucosa were divided into two groups: pancreatic duct end-to-side anastomosis group (group A, 43 cases) and pancreatic jejunal end-to-side anastomosis group (group B, 44 cases). Two different types of pancreaticojejunostomy were compared. The time of pancreaticojejunostomy and the time of hospitalization, Incidence of postoperative complications. Results the mean time of pancreaticojejunostomy (15.4min) in group B was significantly shorter than that in group A (mean 21.1min), and the difference was statistically significant (P 0.05). The postoperative hospitalization time in group B was less than that in group A (t = 2.408, P 0.05, P < 0.05). There was no significant difference in postoperative pancreatic fistula, abdominal hemorrhage, abdominal infection and gastric retention between the two groups (蠂 ~ 2 0.181 ~ 0.322 ~ 0.603 ~ 0. 001P 0.05). Conclusion it is safe and reliable for the pancreaticoduodenectomy not to place the pancreatic duct supporting tube to reduce the operation time and the hospital stay after operation, and there is no significant difference in the incidence of postoperative complications.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R656

【相似文献】