Z'graggen Kaspar, Uhl Waldemar, Friess Helmut, Büchler Markus W
Department of Visceral and Transplantation Surgery, University of Bern, Bern, Switzerland.
J Hepatobiliary Pancreat Surg. 2002;9(6):733-7. doi: 10.1007/s005340200101.
BACKGROUND/PURPOSE: Leakage of pancreaticojejunostomies has been associated with morbidity and mortality after pancreatic head resection. Different techniques have been described to perform a safe anastomosis to the left pancreatic remnant.
The pancreaticojejunostomy is preferably performed as an end-to-side anastomosis; drainage of the pancreatic duct by catheters or stents is not performed at our institution.
Experience in more than 331 patients who underwent pancreaticojejunostomy indicates that a two-layer, single-stitch technique, with absorbable monofilament sutures and duct-to-mucosa adaptation, is a reliable method, with a pancreatic fistula rate of 2%.
The results obtained with the described technique of pancreaticojejunostomy indicate that the pancreatic anastomosis is very safe when performed by experienced hands and does not necessarily contribute to morbidity and mortality after pancreatic head resection. The prevalence of pancreatic fistulae and intraabdominal abscesses may further decrease, and the prevalence of nonpancreatic complications may have a more important impact on the outcome in the future.
背景/目的：胰肠吻合口漏与胰头切除术后的发病率和死亡率相关。已描述了不同技术来对胰腺左残端进行安全吻合。
胰肠吻合术最好采用端侧吻合；我们机构不通过导管或支架对胰管进行引流。
超过331例行胰肠吻合术患者的经验表明，采用可吸收单丝缝线并使胰管与黏膜适配的两层单缝技术是一种可靠方法，胰瘘发生率为2%。
所述胰肠吻合术技术所取得的结果表明，由经验丰富的医生进行胰肠吻合非常安全，不一定会导致胰头切除术后的发病率和死亡率。胰瘘和腹腔内脓肿的发生率可能会进一步降低，非胰腺并发症的发生率在未来可能会对预后产生更重要的影响。
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