Oida Takatsugu, Kano Hisao, Mimatsu Kenji, Kawasaki Atsushi, Kuboi Youichi, Fukino Nobutada, Kida Kazutoshi, Amano Sadao
Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan.
Hepatogastroenterology. 2011 Nov-Dec;58(112):2121-3. doi: 10.5754/hge09562.
BACKGROUND/AIMS: Pancreatic duct dilatation induced anastomotic stenosis of the pancreatic duct is frequently observed in patients who have undergone pancreaticoduodenectomy (PD) with pancreaticogastrostomy (PG). Patency of the pancreaticoenteric anastomosis is one of the most important factors affecting the function of the remnant pancreas and quality of life. Anastomotic stenosis after PG is observed in some patients after approximately 1 to 2 postoperative weeks and is attributed to acute inflammation and fibrosis around the anastomosis. We therefore evaluated the early postoperative changes in remnant pancreatic duct diameter after PG in patients with soft pancreas in terms of delayed gastric emptying (DGE).
We retrospectively studied 42 patients with soft pancreas who underwent PD with PG. They were divided into 2 groups depending on the grade of DGE; without or slightly DGE group (WS group) and moderate or severe DGE group (MS group).
The mean diameter of the pancreatic duct of the remnant pancreas was significantly smaller in the WS group than in the MS group.
DGE accelerates pancreatic anastomotic stricture development after PG in patients having soft pancreas with a pancreatic duct with a small diameter. Hence, to maintain the pancreatic duct patency, preventing DGE is important.
背景/目的：在接受胰十二指肠切除术（PD）并行胰胃吻合术（PG）的患者中，常观察到胰管扩张导致的胰管吻合口狭窄。胰肠吻合口的通畅是影响残余胰腺功能和生活质量的最重要因素之一。PG术后约1至2周，部分患者会出现吻合口狭窄，这归因于吻合口周围的急性炎症和纤维化。因此，我们从胃排空延迟（DGE）方面评估了胰腺质地柔软的患者PG术后残余胰管直径的早期变化。
我们回顾性研究了42例接受PD并行PG的胰腺质地柔软的患者。根据DGE分级将他们分为2组；无或轻度DGE组（WS组）和中度或重度DGE组（MS组）。
WS组残余胰腺的胰管平均直径明显小于MS组。
对于胰腺质地柔软、胰管直径较小的患者，DGE会加速PG术后胰腺吻合口狭窄的发展。因此，为维持胰管通畅，预防DGE很重要。
