Second Department of Surgery, Aretaieion University Hospital, University of Athens, Greece.
Pancreas. 2009 Oct;38(7):e177-82. doi: 10.1097/MPA.0b013e3181b57705.
To evaluate the impact of the length of the isolated jejunal loop and the type of pancreaticojejunostomy on pancreatic leakage after pancreaticoduodenectomy.
One hundred thirty-two consecutive patients who underwent a pancreaticoduodenectomy were studied according to the length of the isolated jejunal loop (short loop, 20-25 cm vs long loop, 40-50 cm) and the type of pancreaticojejunostomy (invagination vs duct to mucosa).
The use of the long isolated jejunal loop was associated with a significantly lower pancreatic leakage rate compared with the use of a short isolated jejunal loop (4.34% vs 14.2%, P < 0.05). In addition, the use of duct-to-mucosa technique was associated with significantly lower incidence of postoperative pancreatic fistula compared with the invagination technique (4.2% vs 14.5%, P < 0.05). Finally, patients with a short isolated jejunal loop compared with patients with a long loop had increased morbidity (50.7% vs 27.5%, P < 0.05) and prolonged hospital stay (16.3 +/- 1.9 days vs 10.2 +/- 2.3 days, P < 0.05). Overall mortality rate was 1.5%.
The use of a long isolated jejunal loop and a duct-to-mucosa pancreaticojejunostomy is associated with decreased pancreatic leakage rate after pancreaticoduodenectomy.
评估空肠袢的长度和胰肠吻合术类型对胰十二指肠切除术后胰漏的影响。
根据空肠袢的长度（短袢，20-25cm 与长袢，40-50cm）和胰肠吻合术的类型（套入式与胰管对黏膜吻合），对 132 例连续接受胰十二指肠切除术的患者进行了研究。
与使用短袢相比，使用长袢与显著较低的胰漏发生率相关（4.34%比 14.2%，P<0.05）。此外，与套入式技术相比，使用胰管对黏膜吻合技术与显著较低的术后胰瘘发生率相关（4.2%比 14.5%，P<0.05）。最后，与长袢患者相比，短袢患者的发病率更高（50.7%比 27.5%，P<0.05），住院时间更长（16.3+/-1.9 天比 10.2+/-2.3 天，P<0.05）。总体死亡率为 1.5%。
使用长袢和胰管对黏膜吻合术与胰十二指肠切除术后胰漏发生率降低有关。
