An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture
An easier method for performing a pancreaticojejunostomy for the soft pancreas using a fast-absorbable suture
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DOI：
10.3748/wjg.14.1091
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发表时间：
2008-02-21
影响因子：
4.3
通讯作者：
Sasaki, Mutsuo
中科院分区：
文献类型：
--
作者：
Hakamada, Kenichi;Narumi, Shunji;Sasaki, Mutsuo
目的：为了阐明一种新的方法进行胰肠吻合术的实用性，通过使用快速可吸收的缝合材料辐照聚乳糖910，和一个临时的支架管狭窄的胰管与软pancreatictexture.METHODS：在63个连续的软胰腺患者进行胰管切除术，从2003年至2006年，35例患者进行了治疗与一种新的重建方法。简言之，在胰腺转移后，将支架管插入胰管内腔，并通过快速可吸收缝线与其结扎。将支架管的另一个头端引入空肠分支处的肠腔内，在此处用另一根快速可吸收缝线进行荷包缝合，以大致固定管。通过结扎两根快速可吸收缝线以使导管末端和空肠粘膜接近，并在胰腺实质和空肠浆肌层之间添加粗糙吻合，完成胰肠吻合术。采用这种方法的初步手术结果进行了回顾性比较，与传统的导管粘膜吻合术治疗的28例患者。结果：术后并发症，包括胰瘘的发生率是两组之间的可比性（新的; 3%-17%与传统的; 7%-14%，根据定义）。无死亡和再次入院。晚期并发症也很少看到。结论：胰肠吻合术使用辐照聚乳糖910缝合材料和临时支架是容易执行，是可行的，即使在病例胰管狭窄和正常的软胰腺。(c)2008年WJG。All rights reserved.
AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS: Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006, 35 patients were treated with a new reconstructive method. Briefly, after the pancreatic transaction, a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fast-absorbable suture. Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb, where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube. The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa, and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum. The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS: The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups (new; 3%-17% vs conventional; 7%-14% according to the definitions). There was no mortality and re-admission. Late complications were also rarely seen.CONCLUSION: A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas. (c) 2008 WJG. All rights reserved.