中国实用外科杂志

中国实用外科杂志

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胰肠吻合口支撑管内引出与外引出早期临床疗效比较

邢国圣，张俊晶，任建军，孟兴凯   

  1. 内蒙古医科大学附属医院普通外科，内蒙古呼和浩特010050
  • 出版日期:2015-03-01 发布日期:2015-03-02

  • Online:2015-03-01 Published:2015-03-02

摘要：

目的    比较胰十二指肠切除术（pancreaticoduodenectomy，PD）后胰肠吻合口支撑管的内引出与外引出的早期临床疗效。方法    回顾性分析内蒙古医科大学附属医院2008年10月至2013年2月间施行PD的118例临床资料，其中纳入观察组共96例，胰腺吻合口支撑管内引出组54例（56.2%），外引出组42例（43.8%）。比较两组病人术前基本情况、手术时间、术后住院时间、病死率及胰瘘等相关并发症发生情况。结果    内引出组发生胰瘘14例（25.9%），外引出组发生胰瘘4例（9.5%），差异有统计学意义（P=0.041）。病人基本情况、术前生化指标、胰腺质地、胰管直径、疾病组成及其他术后并发症（胆瘘、胃肠瘘、二次手术、切口感染、肺部并发症、死亡等）两组间差异无统计学意义。结论    在预防胰瘘上胰管支撑管外引出优于内引出，值得推广。

关键词: 胰十二指肠切除术, 胰管支撑管, 胰瘘

Abstract:

Comparison of the early curative effect of internal versus external stents from pancreaticojejunal anastomosis            XING Guo-sheng，ZHANG Jun-jing，REN Jian-jun，et al. Department of General Surgery, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050，China
Corresponding author：MENG Xing-kai，E-mail：670833275@qq.com
Abstract    Objective    To investigate the effect of pancreatic duct stent internal versus external drainage with pancreaticojejunostomy on the early curative effect after pancreaticoduodenectomy (PD). Methods    The clinical data of 118 cases of PD performed from October 2008 to February 2013 in the Affiliated Hospital of Inner Mongolia Medical University were analyzed retrospectively. A total of 96 case were adopted in the study including internal stent drainage in 54 cases（56.2%）and external stent drainage in 42 cases (43.8%). The two groups were compared in preoperative status，operative duration，postoperative stay，mortality rate and the morbidity of pancreratic fistula as well as other complications. Results    There are 14 case (25.9%) of pancreatic fistula in internal stent group and 4 case (9.5%) of pancreatic fistula in external stent group with significant statistical difference (P=0.041). There was no significant difference in demographic data，presence of comorbid illnesses，underlying pathologies，pancreatic consistency，duct diameter and others complications (biliary fistula，intestinal fistula，reoperation，wound infection，lung complication，death, etc.) between the two groups (P>0.05). Conclusion    Pancreatic duct stent external drainage can reduce the morbidity of pancreatic fistula more effectively than internal drainage, which is worthy of application.

Key words: pancreaticoduodenectomy, pancreatic duct stent, pancreatic fistula