Zhang Xuewen, Xuan Wei, Jiang Tao, Ji Degang, Yang Yongsheng, Zhang Dan, Xie Yingjun, Meng Zihui, Zhao Jisheng
Department of Hepato-biliary-pancreatic surgery, the 3rd Hospital, Jilin University, Changchun, 130033, China.
Front Med China. 2007 Feb;1(1):46-8. doi: 10.1007/s11684-007-0009-3. Epub 2007 Feb 1.
The aim of this paper is to summarize the methods of pancreaticojejunostomy in the pancreatic operation and to study the safety and feasibility of a new operative method called end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture to prevent fistula of pancreaticojejunostomy. Eight-three patients with pancreaticoduodenectomy in the 3rd Hospital, Jilin University from 2001 January to 2006 April were reviewed. The incidences of pancreatic fistula with different types of pancreaticojejunostomy were compared. The overall incidence rate of pancreatic fistula was 26.5% (22/83). No pancreatic fistula occurred in end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture. The incidence rate of the fistula following end-to-end invagination pancreaticojejunostomy with circle discontinuous U suture was significantly lower than that of traditional end-to-end pancreaticojejunostomy [40%, (10/25), P<0.01] and end-to-side pancreaticojejunostomy [27.3%, (12/44), P<0.05], but no significant difference (P>0.05) between traditional end-to-end pancreaticojejunostomy and end-to-side pancreaticojejunostomy was discovered. End-to-end invagination pancreaticojejunostomy with circle discontinuous U suture has a definite effect on avoiding pancreatic fistula following pancreaticojejunostomy and is worth being recommended. But the cases were limited, so this method would still need to be observed and confirmed further in the future.
本文旨在总结胰腺手术中胰肠吻合的方法,并研究一种名为环形间断U形缝合法端端内翻胰肠吻合术的新手术方法预防胰肠吻合口漏的安全性和可行性。回顾了吉林大学第三医院2001年1月至2006年4月行胰十二指肠切除术的83例患者。比较了不同类型胰肠吻合术的胰瘘发生率。胰瘘总发生率为26.5%(22/83)。环形间断U形缝合法端端内翻胰肠吻合术未发生胰瘘。环形间断U形缝合法端端内翻胰肠吻合术后胰瘘发生率明显低于传统端端胰肠吻合术[40%,(10/25),P<0.01]和端侧胰肠吻合术[27.3%,(12/44),P<0.05],但传统端端胰肠吻合术与端侧胰肠吻合术之间无显著差异(P>0.05)。环形间断U形缝合法端端内翻胰肠吻合术对避免胰肠吻合术后胰瘘有确切效果,值得推荐。但病例有限,因此该方法今后仍需进一步观察和证实。