Modified technique of pancreaticogastrostomy for soft pancreas with two continuous hemstitch sutures: a single-center prospective study.
Modified technique of pancreaticogastrostomy for soft pancreas with two continuous hemstitch sutures: a single-center prospective study.
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两次连续缝线胰胃造口术治疗软胰腺的改良技术：单中心前瞻性研究
DOI：
10.1007/s11605-013-2183-8
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发表时间：
2013-07
影响因子：
3.2
通讯作者：
Qin, Renyi
中科院分区：
文献类型：
--
作者：
Zhu, Feng;Wang, Min;Wang, Xin;Tian, Rui;Shi, Chengjian;Xu, Meng;Shen, Ming;Han, Juan;Luo, Ninanian;Qin, Renyi
关键词：
术后胰瘘（POPF）仍然是胰管切除术（PD）后的一个持续性问题，特别是在存在柔软、非纤维化胰腺的情况下。为了降低POPF的风险，胰胃吻合术（PG）是PD后外科医生的一种可选重建技术。 2011年1月至2012年6月，92例壶腹周围恶性肿瘤伴软胰腺患者接受了该技术。采用改良的PG技术，分别在胃后壁的粘膜层和浆肌层中放置两个连续的Hemstitch缝线。计算发病率和死亡率。对92例胰十二指肠切除术后软胰腺患者应用了该技术。吻合的中位时间为12 min（范围：8-24 min）。手术死亡率为0，发病率为16.3%（n = 15），包括出血（n = 2）、胆瘘（n = 2）、肺部感染（n = 1）、胃排空延迟（DGE; n = 5，5.4%）、腹腔脓肿（n = 3，1例由PF引起）和POPF（n = 2，2.2%）。根据国际胰瘘研究组的分类，2例患者发生胰瘘（1例A型和1例B型）。所描述的技术是腹膜透析后的一种简单而安全的重建手术，尤其适用于胰腺柔软脆弱的患者。
Postoperative pancreatic fistula (POPF) remains a persistent problem after pancreaticoduodenectomy (PD), especially in the presence of a soft, nonfibrotic pancreas. To reduce the risk of POPF, pancreaticogastrostomy (PG) is an optional reconstruction technique for surgeons after PD. From January 2011 to June 2012, 92 cases of patients with periampullary malignancy with a soft pancreas underwent this technique. A modified technique of PG was performed with two continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall, respectively. Then the morbidity and mortality was calculated. This technique was applied in 92 patients after PD all with soft pancreas. The median time for the anastomosis was 12 min (range, 8–24). Operative mortality was zero, and morbidity was 16.3 % (n = 15), including hemorrhage (n = 2), biliary fistula (n = 2), pulmonary infection (n = 1), delayed gastric emptying (DGE; n = 5, 5.4 %), abdominal abscess (n = 3, one caused by PF), and POPF (n = 2, 2.2 %). Two patients developed a pancreatic fistula (one type A and one type B) classified according to the International Study Group on Pancreatic Fistula. The described technique is a simple and safe reconstruction procedure after PD, especially for patients with a soft and fragile pancreas.
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影响因子：
9
作者：
Bassi, C;Falconi, M;Pederzoli, P
通讯作者：
Pederzoli, P
DOI：
10.1007/s00534-005-1035-7
发表时间：
2006-01-01
期刊：
JOURNAL OF HEPATO-BILIARY-PANCREATIC SURGERY
影响因子：
--
作者：
Butturini, Giovanni;Marcucci, Stefano;Bassi, Claudio
通讯作者：
Bassi, Claudio
影响因子：
9
作者：
Cameron, JL;Riall, TS;Belcher, KA
通讯作者：
Belcher, KA
影响因子：
3.7
作者：
Govindarajan, Anand;Tan, Jensen C. C.;Law, Calvin H. L.
通讯作者：
Law, Calvin H. L.
影响因子：
1.5
作者：
Bartsch DK;Langer P;Kanngießer V;Fendrich V;Dietzel K
通讯作者：
Dietzel K