胰十二指肠或中段胰腺切除后胰腺残端-消化道的重建方式主要包括胰肠吻合和胰胃吻合两大类。两种吻合方式在围手术期并发症尤其是胰瘘发生率方面差异无统计学意义，胰胃吻合对胰腺远期内外分泌功能的影响尚不明了。对有望获得长期生存，或已经有胰腺内外分泌功能不全的病人，为避免远期的进一步损害，选择胰肠吻合较合理；而对于中段胰腺切除或胰管内乳头状黏液性肿瘤（IPMNs）的病人，可考虑胰胃吻合。总之，选择何种重建方式应综合考虑术者的操作习惯、手术方式、原发疾病的性质、胰腺的质地和内外分泌功能状态等诸多因素。

Reasonable option and evaluation of pancreaticojejunostomy and pancreaticogastrostomy        LOU Wen-hui. Department of General Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Abstract    There are two categories of reconstruction after pancreaticoduodenectomy and segmental pancreatectomy, pancreaticojejunostomy and pancreaticogastrostomy. There is no difference on the incidence of pancreatic fistula between pancreaticojejunostomy and pancreaticogastrostomy. The influence of pancreaticogastrostomy on the exocrine and endocrine function is still unclear. To those patients with longer survival expectation and those with detrimental exocrine and endocrine function, pancreaticojejunostomy is a reasonable option to avoid further damage. To those accept segmental pancreatectomy or those with IPMNs, pancreaticogastrostomy maybe a reasonable option. After all, the choice of digestive tract reconstruction should be based on comprehensive consideration of factors such as operator’s habit, type of operation, nature of original disease, the texture and the state of exocrine and endocrine function.