Fabre J M, Arnaud J P, Navarro F, Bergamaschi R, Cervi C, Marrel E, Domergue J
Department of Digestive Surgery, CHU Montpellier, France.
Br J Surg. 1998 Jun;85(6):751-4. doi: 10.1046/j.1365-2168.1998.00648.x.
The advantages of pancreatogastrostomy over pancreatojejunostomy after pancreaticoduodenectomy are still debated. This study analyses the results of pancreatogastrostomy to identify factors that could influence immediate outcome.
During a 10-year period, 160 consecutive patients underwent a pancreatogastrostomy. There were 109 men (68 per cent) and 51 women (32 per cent) with a mean(s.d.) age of 59(10) (range 22-82) years; 27 patients were older than 70 years. The following parameters were assessed: mortality rate, morbidity, reasons for reoperation, length of hospital stay, duration of nasogastric tube and drainage.
Hospital mortality rate was 3 per cent; overall morbidity rate was 30 per cent. The reoperation rate was 12 per cent, mainly because of bleeding at the pancreatic margin. Delayed gastric emptying occurred in 36 patients. The overall rate of pancreatic fistula was 2.5 per cent. Age, sex, indications for pancreatoduodenectomy, and the texture of the pancreatic remnant did not influence the occurrence of pancreatic fistula or delayed gastric emptying.
This study confirmed that pancreatogastrostomy is a safe procedure with low mortality and morbidity rates.
胰十二指肠切除术后，胰胃吻合术相对于胰空肠吻合术的优势仍存在争议。本研究分析了胰胃吻合术的结果，以确定可能影响近期疗效的因素。
在10年期间，连续160例患者接受了胰胃吻合术。其中男性109例（68%），女性51例（32%），平均（标准差）年龄为59（10）岁（范围22 - 82岁）；27例患者年龄超过70岁。评估了以下参数：死亡率、发病率、再次手术原因、住院时间、鼻胃管留置时间和引流时间。
医院死亡率为3%；总体发病率为30%。再次手术率为12%，主要原因是胰腺切缘出血。36例患者发生胃排空延迟。胰瘘总发生率为2.5%。年龄、性别、胰十二指肠切除的适应证以及胰腺残端的质地均不影响胰瘘或胃排空延迟的发生。
本研究证实胰胃吻合术是一种安全的手术，死亡率和发病率较低。
