Department of Surgery, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University, Minami-ku, Japan.
Am J Surg. 2011 Jul;202(1):77-81. doi: 10.1016/j.amjsurg.2010.04.023. Epub 2011 May 19.
Management of the pancreatic remnant after distal pancreatectomy remains a clinically relevant problem and a significant clinical challenge. We evaluated the safety and efficacy of duct-to-mucosa pancreaticogastrostomy for preventing pancreatic fistula development after distal pancreatectomy.
Twenty-one patients underwent distal pancreatectomy using the duct-to-mucosa pancreaticogastrostomy and the clinical data were collected prospectively. Pancreatic fistula was defined and classified according to the international study group definition.
The median surgical time was 236 minutes, with a median intraoperative blood loss of 250 mL. Morbidity was 5% and mortality was nil. The postoperative pancreatic fistula rate of clinically relevant grade B or C fistulae was 0%, although the biochemical grade A fistula rate was 29%. Delayed gastric emptying developed in only 1 patient (5%).
Duct-to-mucosa pancreaticogastrostomy may be a safe and effective technique for preventing pancreatic fistula development after distal pancreatectomy when performed by experienced surgeons who are skilled in this technique.
远端胰腺切除术后胰腺残端的处理仍然是一个临床相关问题，也是一个重大的临床挑战。我们评估了黏膜胰腺管吻合术在预防远端胰腺切除术后胰瘘发生方面的安全性和有效性。
21 例患者接受了黏膜胰腺管吻合术的远端胰腺切除术，并前瞻性地收集了临床数据。胰瘘根据国际研究组的定义进行定义和分类。
中位手术时间为 236 分钟，术中中位出血量为 250 毫升。发病率为 5%，死亡率为零。临床上有意义的 B 级或 C 级胰瘘的术后胰瘘发生率为 0%，尽管生化 A 级胰瘘的发生率为 29%。只有 1 例（5%）患者发生延迟性胃排空。
当经验丰富的外科医生熟练掌握该技术时，黏膜胰腺管吻合术可能是预防远端胰腺切除术后胰瘘发生的一种安全有效的技术。
