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捆绑式胰肠吻合术在胰十二指肠切除术中的应用

APPLICATION OF BINDING PANCREATICOJEJUNOSTOMY IN PANCREATUODENECTOMY

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【作者】 高涌刘付宝刘金新崔培元李宗狂刘会春

【Author】 GAO Yong,LIU Fu bao, LIU Jin xin,et al.Department of General Surgery Affiliated Hospital of Beng bu Medical College, An hui,233004,China)

【机构】 蚌埠医学院附属医院普外科蚌埠医学院附属医院普外科 蚌埠233004蚌埠233004

【摘要】 目的 探讨捆绑式胰肠吻合术在胰十二指肠切除术后预防胰肠吻合口漏的临床价值。方法 按照彭淑牖教授设计的胰肠捆绑式吻合法进行胰肠吻合 ,游离胰腺断端 3cm,胰管内置硅胶管 ,两者用丝线固定 ,空肠 3cm处断端用电凝或石炭酸破坏其粘膜 ,胰断端套入空肠内 3cm,空肠断端与就近胰包膜缝合 4针 ,并用生物蛋白胶外涂一周 ,距空肠断面约 1~ 2cm处用粗丝线环绕空肠壁捆绑一道 ,使空肠壁与胰腺紧密相贴。结果 经过连续 1 7例临床应用 ,均未发生胰瘘 ,恢复顺利。结论 本法操作方便 ,简单 ,是胰肠吻合理想的手术方式 ,值得推广。

【Abstract】 Objective To study the safety and feasibility of binding pancreaticojejunostomy(BPJ) for the prevention of postoperat pancreatic fistula after pancreatoduodenectomy(PD) Methods According to the ways of BPJ designed by professor PengShu You , the distal end of pancreas was freed for 3 cm,asilica glue tube was implanted into pancreatic duct and fixed with silk. A length of 3 cm distal jejunal mucosa was destroyed with carbolic acid. The distal pancrease was enveloped with the mucosa destroyed jejunum for 3 cm , and a loop of biologic pastern in the near pancreatic envelope was made. After that, a circuit of binding ligation surrounding the wall of jujunum were performed with coarse silks at the sites of 1 to 2 cm. Result No pancreatic fistula was found in our 17 successive patients undergoing such procedure. They all recovered successfully. Conclusion Owing its convenience, simplicity and safety, the procedure is an ideal operative type of pancreaticojejumostomy and deserves further spread.

【关键词】 胰腺胰头十二指肠切除胰瘘
【Key words】 PancreasePancreticojejumostomyPancreatic fistual
  • 【文献出处】 肝胆外科杂志 ,Journal of Hepatobiliary Surgery , 编辑部邮箱 ,2004年02期
  • 【分类号】R656
  • 【下载频次】73
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