大网膜固定术预防胆管癌左肝切除联合淋巴结清扫术后胃排空延迟

Fixation of the greater omentum for prevention of delayed gastric emptying after left hepatectomy with lymphadenectomy for cholangiocarcinoma.

作者信息

Yoshida Hiroshi, Mamada Yasuhiro, Taniai Nobuhiko, Mizuguchi Yoshiaki, Shimizu Tetsuya, Kakinuma Daisuke, Ishikawa Yoshinori, Kanda Tomoharu, Matsumoto Satoshi, Yokomuro Shigeki, Akimaru Koho, Tajiri Takashi

机构信息

Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

出版信息

J Hepatobiliary Pancreat Surg. 2007;14(4):392-6. doi: 10.1007/s00534-006-1201-6. Epub 2007 Jul 30.

DOI:10.1007/s00534-006-1201-6

PMID:17653639

Abstract

BACKGROUND/PURPOSE: Delayed gastric emptying (DGE) sometimes occurs after left hepatectomy with lymphadenectomy. We performed fixation of the greater omentum to the peritoneum to prevent DGE and other complications in patients undergoing left hepatectomy with lymphadenectomy for cholangiocarcinoma.

METHODS

Patients undergoing left hepatectomy with lymphadenectomy for cholangiocarcinoma were divided into a fixation group (n = 9) and a nonfixation group (n = 10). In the fixation group, the greater omentum was sutured to the peritoneum 3 cm from the greater curvature of the stomach to prevent contact between the stomach and the cut surface of the liver.

RESULTS

Mean age, sex, disease, and hepatectomy procedures were similar in the two groups. DGE developed in six patients in the nonfixation group (60.0%) versus no patients in the fixation group (P = 0.011). The total number of complications was higher in the nonfixation group (16 complications) than in the fixation group (3 complications; P = 0.003). Overall morbidity was higher in the nonfixation group (60.0%) than in the fixation group (22.2%). Postoperative hospitalization was longer in the nonfixation group (67.4 days) than in the fixation group (20.2 days; P = 0.0041).

CONCLUSIONS

Fixation of the greater omentum to the peritoneum decreases the occurrence of DGE and other complications after left hepatectomy with lymphadenectomy for cholangiocarcinoma.

摘要

背景/目的：在左肝切除联合淋巴结清扫术后，有时会发生胃排空延迟（DGE）。我们对大网膜进行腹膜固定术，以预防接受胆管癌左肝切除联合淋巴结清扫术患者发生DGE及其他并发症。

方法

将接受胆管癌左肝切除联合淋巴结清扫术的患者分为固定组（n = 9）和非固定组（n = 10）。在固定组中，将大网膜缝合至距胃大弯3 cm处的腹膜，以防止胃与肝脏切面接触。

结果

两组患者的平均年龄、性别、疾病及肝切除手术方式相似。非固定组有6例患者发生DGE（60.0%），而固定组无患者发生（P = 0.011）。非固定组的并发症总数（16例）高于固定组（3例；P = 0.003）。非固定组的总体发病率（60.0%）高于固定组（22.2%）。非固定组的术后住院时间（67.4天）长于固定组（20.2天；P = 0.0041）。