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目的:探讨胰十二指肠切除术中胰腺空肠端侧吻合技术。方法:回顾性分析山东大学齐鲁医院肝胆外科2004年3月—2012年6月156例胰十二指肠切除术行胰腺空肠端侧吻合患者的临床资料。根据胰腺的质地、厚度、胰管直径、胰管后壁胰腺组织的厚度、有无炎症,结合空肠的直径、空肠壁的厚度选择胰管-空肠黏膜-黏膜吻合、端侧套入式吻合等不同的吻合方式。结果:术中胰肠重新吻合8例。术后胰瘘3例、胆瘘2例、死亡2例。结论:胰十二指肠切除术中胰腺空肠吻合应根据患者的胰腺和空肠情况进行个体化选择。
Objective: To investigate the end-to-end anastomosis of pancreatic jejunum in pancreaticoduodenectomy. Methods: The clinical data of 156 patients with pancreatic jejunum end-to-side anastomosis underwent pancreaticoduodenectomy from March 2004 to June 2012 in Hepatobiliary Surgery of Qilu Hospital of Shandong University were retrospectively analyzed. Pancreatic duct - jejunum mucosa - mucosa anastomosis, end - side intussusception anastomosis and so on according to the quality of the pancreas, the thickness, the diameter of the pancreatic duct, the thickness of the pancreas in the posterior wall of the pancreatic duct, the presence or absence of inflammation, the diameter of the jejunum and the thickness of the jejunum wall Different ways of matching. Results: Intraoperative pancreaticojejunostomy in 8 cases. 3 cases of postoperative pancreatic fistula, 2 cases of biliary fistula, 2 died. CONCLUSIONS: Pancreatic jejunostomy during pancreatoduodenectomy should be individually selected based on the patient’s pancreas and jejunum.