Li Song-gang, Shi Wei-bin, Mei Jia-wei, Wang Jian-dong, Shen Jun, Zhou Xue-ping, Wang Xue-feng
Department of General Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China.
Zhonghua Wai Ke Za Zhi. 2013 May 1;51(5):400-2.
To explore the effect of drainage in cavities on preventing from grade B and C of the pancreatic fistula after pancreaticoduodenectomy (PD).
From June 2008 to June 2010, the medical team had performed the operations of digestive tract reconstruction by the same way in 68 cases with PD. There were 43 male and 25 female patients, with a mean age of (64 ± 3) years. The patients were simply randomly divided into drainage in cavities group (DC, n = 32) and conventional drainage group (CD, n = 36) according to the different drainage way. The methods of drainage in cavities were composed of three aspects which include drainage in main pancreatic duct, drainage around cholecystojejunostomy anastomosis and peripancreatic drainage. The clinical parameters of the two groups were collected. The characteristics of the drainage juice which include color, volume and amylase value in the two groups were compared. The incidence and severity grading of pancreatic fistula between the two groups were evaluated.
The average of amylase value and the peripancreatic drainage flow were (1401 ± 8) U/L and (49 ± 5) ml in the DC group. Their average in the CD group were (2160 ± 13) U/L and (76 ± 4) ml. There was significant statistical difference in the peripancreatic drainage flow between the two groups (t = 2.597, P = 0.031). The amylase values of the drainage juice between the two groups were of no statistical difference (P > 0.05). According to the definition of pancreatic fistula by an international study group, the incidence of pancreatic fistula in the DC group was 25.0% (8/32) and the CD group 30.5% (11/36) (P > 0.05). The proportion of grades B and C of pancreatic fistula in the DC group had statistical difference compared with one of the CD group (χ(2) = 4.797, P = 0.029).
Drainage in cavities could significantly decrease and the occurring ratio of grade B and C of pancreatic fistula after PD.
探讨胰十二指肠切除术后（PD）胰腔引流对预防B级和C级胰瘘的作用。
2008年6月至2010年6月，医疗团队对68例行PD手术的患者采用相同方式进行消化道重建。其中男性43例，女性25例，平均年龄（64±3）岁。根据引流方式不同，将患者简单随机分为胰腔引流组（DC组，n = 32）和传统引流组（CD组，n = 36）。胰腔引流方法包括主胰管引流、胆肠吻合口周围引流和胰周引流三个方面。收集两组的临床参数。比较两组引流液的颜色、量和淀粉酶值等特征。评估两组胰瘘的发生率和严重程度分级。
DC组淀粉酶值平均为（1401±8）U/L，胰周引流量平均为（49±5）ml；CD组淀粉酶值平均为（2160±13）U/L，胰周引流量平均为（76±4）ml。两组胰周引流量差异有统计学意义（t = 2.597，P = 0.031）。两组引流液淀粉酶值差异无统计学意义（P＞0.05）。根据国际研究组对胰瘘的定义，DC组胰瘘发生率为25.0%（8/32），CD组为30.5%（11/36）（P＞0.05）。DC组B级和C级胰瘘的比例与CD组相比有统计学差异（χ² = 4.797，P = 0.029）。
胰腔引流可显著降低PD术后B级和C级胰瘘的发生率。
