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目的总结胰十二指肠切除术后胰胃吻合术的临床应用经验。方法回顾性分析本院2007年5月至2010年12月间接受胰十二指肠切除术后胰胃吻合术16例患者的临床资料。全组患者接受将胰腺残端套入胃后壁方式吻合,采用术后检测引流液淀粉酶浓度方法诊断是否出现胰瘘。结果 16例患者手术均顺利完成,平均手术时间(361.1±82.4)min,术中平均输血量(702.5±517.8)ml;术后住院时间平均(19.5±10.9)d;术后并发症3例(18.8%),其中胰瘘并腹腔积液、腹腔出血1例,胰腺残端出血1例,切口感染1例。无住院期间因手术死亡病例。结论胰十二指肠切除术时,根据患者的具体情况合理地选择胰胃吻合是可行及安全的。
Objective To summarize the clinical experience of pancreaticoduodenectomy after pancreatoduodenectomy. Methods The clinical data of 16 patients who underwent pancreaticoduodenectomy after pancreaticoduodenectomy between May 2007 and December 2010 in our hospital were retrospectively analyzed. All patients underwent pancreatic stump nested into the posterior wall of the stomach anastomosis, using the detection of drainage fluid amylase concentration method for the diagnosis of pancreatic fistula. Results The operation time of all the 16 patients was successfully completed. The average operation time was (361.1 ± 82.4) min. The mean intraoperative blood transfusion was (702.5 ± 517.8) ml. The postoperative hospital stay was (19.5 ± 10.9) days. The postoperative complications were 3 18.8%), including pancreatic fistula and peritoneal effusion, abdominal bleeding in 1 case, 1 case of pancreatic stump hemorrhage, incision infection in 1 case. No cases of death due to surgery during hospitalization. Conclusions During pancreatoduodenectomy, it is feasible and safe to choose pancreatic and gastric anastomosis reasonably according to the specific conditions of patients.