A simple and safe anastomosis for pancreatogastrostomy using one binding purse-string and two transfixing mattress sutures.
A simple and safe anastomosis for pancreatogastrostomy using one binding purse-string and two transfixing mattress sutures.
复制标题
DOI：
10.1155/2012/718637
复制
发表时间：
2012
影响因子：
1.5
通讯作者：
Dietzel K
中科院分区：
文献类型：
--
作者：
Bartsch DK;Langer P;Kanngießer V;Fendrich V;Dietzel K
胰腺吻合口漏在胰腺十二指肠切除术(PD)后仍然是一个持续存在的问题，特别是在存在柔软的非纤维化胰腺的情况下。设计了一种改良的胰胃吻合术，即在胰腺残端和胃后壁之间结合一条捆绑荷包和两条贯穿床垫缝合。该技术应用于35例恶性和良性疾病PD后，其中10例(28.6%)出现胰腺软组织。中位吻合时间为18 分钟。手术死亡率为0，并发症发生率为34.3%。根据国际胰瘘研究小组的分类，3例(8.6%)患者发生胰瘘(2例A型，1例B型)。所有瘘管在没有进一步干预的情况下消失。所描述的技术是一种简单安全的PD后重建方法，值得进一步评估。
Pancreatic anastomotic leakage remains a persistent problem after pancreaticoduodenectomy (PD), especially in the presence of a soft, nonfibrotic pancreas. A modified technique for pancreatogastrostomy was devised, which combines one binding purse-string and two transfixing mattress sutures between the pancreatic stump and the posterior gastric wall. This technique was applied in 35 patients after PD for malignant and benign diseases of whom 10 (28.6%) had a soft pancreas. Median time for the anastomosis was 18 minutes. Operative mortality was zero, and morbidity was 34.3%. Three (8.6%) patients developed a pancreatic fistula (2 type A, 1 type B) as classified according to the International Study Group on pancreatic fistula. All fistulas resolved without further intervention. The described technique is a simple and safe reconstruction procedure after PD that warrants further evaluation.