Icard P, Dubois F
Department of Digestive Surgery C.M.C. de la Porte de Choisy, Paris, France.
Ann Surg. 1988 Mar;207(3):253-6. doi: 10.1097/00000658-198803000-00005.
Operative death following pancreatoduodenectomy results essentially from a pancreatojejunal anastomosis leakage. Pancreaticogastrostomy has been used infrequently. Seventeen patients (12 with malignant tumors and 5 with chronic pancreatitis) have undergone pancreaticogastrostomy following pancreatoduodenectomy. There was no operative mortality rate and no pancreaticogastrostomy leakage. Our data agree with data concerning pancreaticogastrostomy published in literature; cumulative mortality rate including our results is 4.5% (6 out of 134 patients) with only one transient benign pancreatic fistula reported. Many advantages offered by this method can explain these positive results including trypsine neutralization by gastric acidity and the possibility of nasogastric aspiration on contact with the anastomosis. Furthermore, permeability of the pancreatic duct can be easily verified by endoscopic examination. However, external pancreatic insufficiency does not seem to occur in long-term follow-up. These results suggest that this simple and safe method merits a more widespread application.
胰十二指肠切除术后的手术死亡主要源于胰空肠吻合口漏。胰胃吻合术的应用并不常见。17例患者（12例患有恶性肿瘤，5例患有慢性胰腺炎）在胰十二指肠切除术后接受了胰胃吻合术。无手术死亡率，也无胰胃吻合口漏。我们的数据与文献中发表的有关胰胃吻合术的数据一致；包括我们的结果在内，累积死亡率为4.5%（134例患者中有6例），仅报告了1例短暂性良性胰瘘。该方法具有的诸多优点可以解释这些阳性结果，包括胃酸对胰蛋白酶的中和作用以及与吻合口接触时进行鼻胃抽吸的可能性。此外，通过内镜检查可以轻松验证胰管的通畅性。然而，在长期随访中似乎并未出现外分泌性胰腺功能不全。这些结果表明，这种简单且安全的方法值得更广泛地应用。
