胰肠套入式一层缝合在胰十二指肠切除术中的应用：一项回顾性队列研究。
Application of pancreaticojejunostomy with one-layer suture in pancreaticoduodenectomy: A retrospective cohort study.
机构信息
Department of General Surgery, Qilu Hospital of Shan Dong University, NO 107 West Wenhua Road, Jinan, 250012, China.
Department of Organ Transplantation, Qilu Hospital of Shan Dong University, NO 107 West Wenhua Road, Jinan, 250012, China.
出版信息
Int J Surg. 2018 Aug;56:68-72. doi: 10.1016/j.ijsu.2018.06.005. Epub 2018 Jun 8.
BACKGROUND
Postoperative pancreatic fistula (POPF) is the most common critical complication after pancreaticoduodenectomy (PD) and a primary reason for increased mortality and morbidity after PD. To perform a safe pancreaticojejunostomy (PJ), a fast and simple technique of duct-to-mucosa PJ with one-layer suture was devised at our institution.
MATERIALS AND METHODS
We conducted a retrospective analysis of 81 successive cases of PD performed at our hospital from March 2012 to August 2016. Data of perioperative parameters were collected for all PD cases.
RESULTS
A total of 17 (21.0%) cases of morbidity occurred after PD, including 5 (6.1%) cases of POPF (grade A), 8 (9.8%) cases of delayed gastric emptying, 1 (1.2%) case of abdominal infection, and 3 (3.7%) cases of incision infection. The median operative time for the PJ was 7 min. No mortality or relaparotomy was observed.
CONCLUSION
Our technique could significantly reduce the incidence of POPF and other complications after PD and may be a promising technique for pancreaticoenteric anastomosis.
背景
胰十二指肠切除术（PD）后，胰瘘（POPF）是最常见的严重并发症，也是 PD 术后死亡率和发病率增加的主要原因。为了进行安全的胰肠吻合术（PJ），我们在机构内设计了一种快速、简单的导管黏膜单层缝合 PJ 技术。
材料和方法
我们对 2012 年 3 月至 2016 年 8 月在我院进行的 81 例连续 PD 病例进行了回顾性分析。收集了所有 PD 病例的围手术期参数数据。
结果
PD 后共有 17 例（21.0%）发生并发症，包括 5 例（6.1%）POPF（A级）、8 例（9.8%）胃排空延迟、1 例（1.2%）腹部感染和 3 例（3.7%）切口感染。PJ 的中位手术时间为 7 分钟。无死亡或再次剖腹手术。
结论
我们的技术可以显著降低 PD 后 POPF 和其他并发症的发生率，可能是一种有前途的胰肠吻合技术。
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