Nanashima Atsushi, Sumida Yorihisa, Abo Takafumi, Shindo Hisakazu, Fukuoka Hidetoshi, Tanaka Kenji, Takeshita Hiroaki, Hidaka Shigekazu, Sawai Terumitsu, Yasutake Toru, Nagayasu Takeshi
Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Hepatogastroenterology. 2007 Jun;54(76):1243-6.
BACKGROUND/AIMS: The relative advantages of pancreaticojejunostomy and pancreaticogastrostomy after pancreaticoduodenectomy remain to be established. To clarify differences between the two procedures, we examined 66 patients who underwent PD and compared clinical and histological parameters, surgical records and patient outcomes.
In this retrospective study, subjects were divided into a pancreaticojejunostomy group (n=48) and a pancreaticogastrostomy group (n=18). Pancreaticogastrostomy and pancreaticojejunostomy were performed using invagination technique and end-to-side anastomosis, respectively.
There were no significant differences in patient demographics and surgical records between the two groups. Increases in serum amylase concentrations after operation were significantly greater in the pancreaticogastrostomy group (902 +/- 915 IU/L) than in the pancreaticojejunostomy group (326 +/- 761 IU/L) (p = 0.025). However, there were no significant differences in other postoperative laboratory data or complications between the two groups.
In our study, the clinical and safety data associated with pancreaticojejunostomy and pancreaticogastrostomy procedures for anastomosis after pancreaticoduodenectomy were almost similar. Therefore, the anastomotic procedure used should depend on the surgeon's choice or the distance between the remnant stomach and pancreas.
背景/目的：胰十二指肠切除术后胰肠吻合术和胰胃吻合术的相对优势仍有待确定。为了阐明这两种手术方法之间的差异，我们对66例行胰十二指肠切除术的患者进行了研究，比较了临床和组织学参数、手术记录及患者预后情况。
在这项回顾性研究中，研究对象被分为胰肠吻合术组（n = 48）和胰胃吻合术组（n = 18）。胰胃吻合术和胰肠吻合术分别采用套入技术和端侧吻合术进行。
两组患者的人口统计学特征和手术记录无显著差异。术后胰胃吻合术组血清淀粉酶浓度升高幅度（902±915 IU/L）显著大于胰肠吻合术组（326±761 IU/L）（p = 0.025）。然而，两组患者的其他术后实验室数据或并发症无显著差异。
在我们的研究中，胰十二指肠切除术后胰肠吻合术和胰胃吻合术的临床及安全性数据几乎相似。因此，所采用的吻合手术方法应取决于外科医生的选择或残胃与胰腺之间的距离。
