改良的卡特尔胰肠吻合术、软胰腺的支撑和孤立的胆胰肠袢是提高胰十二指肠切除术后疗效的安全措施：一项初步研究。
Modified Cattell's pancreaticojejunostomy, buttressing for soft pancreases and an isolated biliopancreatic loop are safety measurements that improve outcome after pancreaticoduodenectomy: a pilot study.
机构信息
Department of Hepatopancreatobiliary Surgery, St. James's University Hospital, Leeds, UK.
出版信息
HPB (Oxford). 2009 Mar;11(2):154-60. doi: 10.1111/j.1477-2574.2009.00028.x.
BACKGROUND
Pancreatic anastomotic leak is one of the most serious complications following pancreaticoduodenectomy (PD). Various factors have been implicated as contributors to pancreatic anastomotic leaks, the incidence of which has been as high as 28% in some series.
OBJECTIVES
We describe technical modifications to Cattell's technique for pancreaticojejunostomy (PJ), with buttressing of 'soft' pancreases and use of an isolated biliopancreatic loop for reconstruction following a PD.
METHODS
We report our early experience using this technique in 50 patients who underwent PD between May 2002 and June 2006.
RESULTS
There was no mortality in our series. The postoperative morbidity rate was 32% (16/50), with major complications occurring in seven (14%) patients. Pancreatic leak occurred in one patient (2%) and bile leak in one patient (2%). Both patients were managed conservatively.
CONCLUSIONS
Reconstruction after PD using an isolated biliopancreatic loop and modifications to Cattell's technique for PJ, with buttressing of the soft pancreas, can be performed with a low risk of pancreatic anastomotic leakage.
背景
胰腺吻合口漏是胰十二指肠切除术（PD）后最严重的并发症之一。各种因素都可能导致胰腺吻合口漏，在某些系列中，其发生率高达 28%。
目的
我们描述了 Cattell 技术在胰肠吻合术中的技术改良，对“软”胰腺进行支撑，并在 PD 后使用孤立的胆胰肠Loop 进行重建。
方法
我们报告了 2002 年 5 月至 2006 年 6 月期间，我们使用该技术对 50 例 PD 患者的早期经验。
结果
本系列中无死亡病例。术后发病率为 32%（16/50），有 7 例（14%）患者发生严重并发症。1 例（2%）患者发生胰漏，1 例（2%）患者发生胆漏。两名患者均保守治疗。
结论
使用孤立的胆胰肠 Loop 和 Cattell 技术改良进行 PD 后重建，对软胰腺进行支撑，可以降低胰腺吻合口漏的风险。
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