胰管与黏膜吻合的胰管空肠吻合术不使用支架管比使用时能更安全地进行。
Pancreaticojejunostomy of duct to mucosa anastomosis can be performed more safely without than with a stenting tube.
作者信息
Suzuki Shuji, Kaji Satoshi, Koike Nobusada, Harada Nobuhiko, Tanaka Seiichi, Hayashi Tsuneo, Suzuki Mamoru, Hanyu Fujio
机构信息
Department of Surgery, Hachioji Digestive Disease Hospital, Hachioji City, Tokyo, Japan.
出版信息
Am J Surg. 2009 Jul;198(1):51-4. doi: 10.1016/j.amjsurg.2008.05.008. Epub 2009 Feb 13.
BACKGROUND
The aim of this study was to evaluate the safety of performing a pancreaticojejunostomy with a duct-to-mucosa anastomosis without a stenting tube.
METHODS
One hundred twenty-one patients with pancreaticojejunostomy, classified into 2 groups of those with duct-to-mucosa anastomoses with stenting tubes (group A; n = 49) and without stenting tubes (group B; n = 72), were investigated. Outcomes, including complications and survival rates, are reported.
RESULTS
In group A, morbidity was 32.7%, 6.7% had pancreatic fistulas, 14.3% had delayed gastric emptying, 6.1% had remnant pancreatitis, 2% had intra-abdominal abscesses, 2% had intra-abdominal bleeding, and mortality was 2%. In group B, morbidity (15.3%) and delayed gastric emptying (2.8%) showed significant differences from group A. Other results were nonsignificant. In the normal soft pancreas, pancreatic fistulas in group B (3.3%) were less frequent than in group A (12.5%).
CONCLUSION
Pancreaticojejunostomy of a duct-to-mucosa anastomosis could be performed more safely without than with a stenting tube to obtain a definitive anastomosis and transection of the pancreas.
背景
本研究的目的是评估在不放置支撑管的情况下进行胰管-黏膜吻合的胰空肠吻合术的安全性。
方法
对121例行胰空肠吻合术的患者进行研究，分为两组，A组为放置支撑管行胰管-黏膜吻合的患者（n = 49），B组为未放置支撑管行胰管-黏膜吻合的患者（n = 72）。报告包括并发症和生存率在内的结果。
结果
A组的发病率为32.7%，6.7%发生胰瘘，14.3%发生胃排空延迟，6.1%发生残余胰腺炎，2%发生腹腔内脓肿，2%发生腹腔内出血，死亡率为2%。B组的发病率（15.3%）和胃排空延迟（2.8%）与A组有显著差异。其他结果无统计学意义。在正常质地柔软的胰腺中，B组的胰瘘发生率（3.3%）低于A组（12.5%）。
结论
胰管-黏膜吻合的胰空肠吻合术在不放置支撑管的情况下比放置支撑管时能更安全地进行，以实现胰腺的确定性吻合和横断。
Zotero 插件