A Modified Technique of End-to-End Pancreaticojejunostomy With Transpancreatic Interlocking Mattress Sutures
A Modified Technique of End-to-End Pancreaticojejunostomy With Transpancreatic Interlocking Mattress Sutures
复制标题
经胰互锁床垫缝线端对端胰空肠吻合术的改良技术
DOI：
10.1002/jso.23319
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发表时间：
2013-06-01
影响因子：
2.5
通讯作者：
Qin, Renyi
中科院分区：
文献类型：
--
作者：
Wang, Min;Zhu, Feng;Qin, Renyi
背景术后胰瘘（POPF）是胰腺切除术（PD）后最重要的发病原因，并导致住院时间延长和死亡率增加。本研究介绍了一种新技术，即经胰腺带锁褥式缝合的胰肠端端吻合术，并评价了其安全性和可靠性。方法自2011年1月至2012年5月，采用改良技术对79例壶腹周围恶性肿瘤患者进行PD，并计算并发症发生率和死亡率。结果本组病例均恢复良好。对79例患者进行了4次经胰腺交锁褥式缝合。手术的中位持续时间为3.9小时（范围3.16.8），进行胰肠吻合的中位时间为15.3分钟（范围924）。总体而言，16例患者发生了发病病因包括上消化道出血2例，胆瘘1例，肺部感染1例，胃排空障碍1例，腹腔脓肿1例（n=1，由PF引起）、伤口感染（n=3）、心律失常或心肌梗死（n=3）、尿路感染（n=2）和POPF（n=2，2.53%）。A级POPF 1例，B级POPF 1例，C级POPF 0例。术中无死亡。结论经胰十二指肠带锁褥式缝合胰肠端端吻合术是一种简单、快速、安全、可靠的方法，POPF发生率低，迟发性大出血发生率低。外科肿瘤学杂志2013年9999年：(c)2013 Wiley Periodicals，Inc.外科肿瘤学杂志2013;107：783788. (c)2013 Wiley Periodicals，Inc.
Background Postoperative pancreatic fistula (POPF) represents the most important cause of morbidity after pancreaticoduodenectomy (PD) and contributes to prolonged hospitalization and increased mortality rates. This study presents a new technique, which involves end-to-end pancreaticojejunostomy with transpancreatic interlocking mattress sutures, and evaluates its safety and reliability. Methods From January 2011 to May 2012, 79 patients with periampullary malignancies underwent PD by using this modified technique, and the morbidity and mortality rates were calculated. Results In this study, all cases recovered well from PD. Four transpancreatic interlocking mattress sutures were performed in 79 patients. The median duration of surgery was 3.9hr (range 3.16.8), and the median time to perform pancreaticojejunostomy was 15.3min (range 924). Overall, morbidity occurred in 16 patients (22.3%), and the causes included upper gastrointestinal bleeding (n=2), biliary fistula (n=1), pulmonary infection (n=1), delayed gastric emptying (n=1), abdominal abscess (n=1, caused by PF), wound infection (n=3), arrhythmia or myocardial infarction (n=3), urinary tract infection (n=2), and POPF (n=2, 2.53%). One patient had grade A POPF, one had grade B POPF, and none of them had grade C POPF. No death occurred during surgery. Conclusion The end-to-end pancreaticojejunostomy with transpancreatic interlocking mattress sutures is a simple, rapid, safe, and reliable technique with low POPF rate and low delayed massive hemorrhage rate. J. Surg. Oncol. 2013 9999:XXXX. (c) 2013 Wiley Periodicals, Inc. J. Surg. Oncol. 2013;107:783788. (c) 2013 Wiley Periodicals, Inc.