Kim Dong Jin, Paik Kwang Yeol, Kim Wook, Kim Eung Kook
Hepatogastroenterology. 2014 Jul-Aug;61(133):1421-5.
BACKGROUND/AIMS: Pancreatic fistula (PF) has traditionally been a source of significant morbidity and mortality after pancreaticoduodenectomy (PD). External drainage of pancreatic duct with stent and Blumgart anastomosis had reduced PF after PD in some studies. We applied compounding described two methods for pancreaticojejunostomy (PJ) during PD, and investigated the effectiveness of this modified PJ technique to prevent PF.
Between March 2002, and March 2013, 90 patients who underwent PD were enrolled. The patients were divided into 2 groups according to pancreatienterostomy method. Group 1 contain patients who did not undergo modified PJ (n=70) compared with group 2 (n=20) those who did undergo the modified PJ technique. We compared clinical data between two groups.
No differences were noted in the demographics and operation-related factors, between the 2 groups. A PF occurred in 38 of 70 patients in group 1 (54.3%) and in 2 of 20 in group 2 (10.0%). Group 2 had a significantly lower incidence of PF (P=.0016), and these fistulas were classified as being grade A using the International Study Group on Pancreatic Fistula Definition. Mortality in group 1 was 10.0% and no mortality in group 2.
External drainage with Blumgart method of PJ showed reducing high grade PF after PD.
背景/目的：胰瘘（PF）一直是胰十二指肠切除术（PD）后严重发病和死亡的重要原因。在一些研究中，使用支架进行胰管外引流和Blumgart吻合术降低了PD后的胰瘘发生率。我们应用复合方法描述了在PD期间进行胰空肠吻合术（PJ）的两种方法，并研究了这种改良PJ技术预防胰瘘的有效性。
2002年3月至2013年3月期间，纳入90例行PD的患者。根据胰肠吻合方法将患者分为2组。第1组包括未进行改良PJ的患者（n = 70），与第2组（n = 20）进行改良PJ技术的患者进行比较。我们比较了两组之间的临床数据。
两组在人口统计学和手术相关因素方面没有差异。第1组70例患者中有38例（54.3%）发生胰瘘，第2组20例中有2例（10.0%）发生胰瘘。第2组胰瘘发生率显著较低（P = 0.0016），根据国际胰瘘研究组的定义，这些瘘被分类为A级。第1组的死亡率为10.0%，第2组无死亡病例。
采用Blumgart法进行PJ外引流可降低PD后的高等级胰瘘发生率。
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