Department of General Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China.
JAMA Surg. 2014 Jun;149(6):604-7. doi: 10.1001/jamasurg.2013.3399.
A retrograde dissection technique of pancreaticoduodenectomy in a caudocranial direction has been described recently.
Fifteen consecutive patients who underwent retrograde pancreaticoduodenectomy were compared with 15 consecutive patients operated on through a conventional approach. The mean (SD) intraoperative blood loss was 407 (202) mL in the retrograde group compared with 423 (253) mL in the conventional group (P = .84). The mean (SD) operative duration was 255 (57) minutes in the retrograde group compared with 264 (54) minutes in the conventional group (P = .66). The overall morbidity was 7 of 15 patients (47%) in the retrograde group and 6 of 15 (40%) in the conventional group (P > .99). Neither group had a positive resection margin or a perioperative death.
The retrograde dissection technique had no significant difference in perioperative outcomes compared with the conventional dissection technique and could serve as an alternative dissection approach in pancreaticoduodenectomy.
最近描述了一种顺行向逆行胰十二指肠切除术的逆行解剖技术。
将 15 例连续接受逆行胰十二指肠切除术的患者与 15 例通过传统方法手术的连续患者进行比较。逆行组术中失血量平均（标准差）为 407（202）mL，传统组为 423（253）mL（P=0.84）。逆行组的平均（标准差）手术时间为 255（57）分钟，传统组为 264（54）分钟（P=0.66）。逆行组 15 例患者中有 7 例（47%）出现总并发症，传统组有 6 例（40%）（P>.99）。两组均无阳性切缘或围手术期死亡。
与传统解剖技术相比，逆行解剖技术在围手术期结果方面没有显著差异，可作为胰十二指肠切除术的替代解剖方法。
