帮助 关于我们

返回检索结果

胰管空肠黏膜对黏膜双层连续吻合法在全腹腔镜胰十二指肠切除术中的应用
Application of Pancreaticojejunostomy With Pancreatic Duct-jejunum Mucosa-mucosal Double-layer Continuous Suture in Total Laparoscopic Pancreaticoduodenectomy: a Report of 105 Cases

查看参考文献18篇

文摘 目的探讨使用支撑管及胰管-空肠黏膜对黏膜双层连续缝合法行胰肠端侧吻合在全腹腔镜胰十二指肠切除术(laparoscopic pancreaticoduodenectomy,LPD)中的应用价值。方法回顾性分析2013年8月~ 2018年10月105例LPD中应用支撑管及胰管-空肠黏膜对黏膜双层连续缝合法行胰肠端侧吻合的临床资料。结果105例均顺利完成LPD。手术时间360 ~ 640(465.1 ± 53.8) min,术中出血量100 ~ 2800(356.9 ± 296.2) ml。术后并发症发生率29.5%(31/105):出血18例(17.1%),其中消化道出血7例,腹腔出血11例;漏10例(9.5%),其中胆漏2例,胰漏8例,胰漏发生于术后3 ~ 9(5.0 ± 2.1) d,包括B级3例,C级5例;感染15例(14.3%);胃排空障碍3例(2.9%) 。良性病变19例(18.1%),恶性病变86例(81.9%) 。淋巴结清扫1 ~ 33(10.6 ± 7.1)个,R0切缘率96.5%(83/86) 。围术期死亡5例(4.8%),其余100例术后腹腔引流管放置5 ~ 46(14.4 ± 6.4) d,术后住院时间6 ~ 46(18.3 ± 6.4) d,总住院时间15 ~ 62(27.1 ± 7.8) d。非计划再次手术6例(5.7%) 。结论LPD中应用支撑管及胰管-空肠黏膜对黏膜双层连续缝合法行胰肠端侧吻合是安全、可行的。
其他语种文摘 Objective To explore the clinical practice of placing stenting tube and performing end-to-side pancreaticojejunostomy with pancreatic duct-jejunum mucosa-mucosal double-layer continuous suture in laparoscopic pancreaticoduodenectomy (LPD). Methods We retrospectively summarized clinical data of 105 patients who were placed a stenting tube and underwent end-to-side pancreaticojejunostomy with pancreatic duct-jejunum mucosa-mucosal double-layer continuous suture in LPD from August 2013 to October 2018 in our hospital. Results All the 105 patients underwent classical LPD successfully. The operation time was 360 - 640 min (mean,465.1 ± 53.8 min),and the intraoperative blood loss was 100 - 2800 ml (mean,356.9 ± 296.2 ml). There were 31 cases (29.5%) of postoperative complications,including 18 cases (17.1%) of hemorrhage (gastrointestinal hemorrhage in 7 cases,abdominal bleeding in 11 cases),10 cases (9.5%) of leakage [2 cases of biliary leakage and 8 cases of pancreatic leakage; the latter occurred on 3 - 9 d (mean,5.0 ± 2.1 d) after surgery; 3 were classified as grade B and 5 as grade C],15 cases (14.3%) of infection,and 3 cases (2.9%) of delayed gastric emptying. Pathological results showed 19 cases (18.1%) of benign tumors and 86 cases (81.9%) of malignant cancers. The number of lymph node resected was 1 - 33 (mean,10.6 ± 7.1),and the R0 resection rate was 96.5% (83/86) in patients with malignant cancers. The postoperative mortality was 4.8% (5/105). In the remaining 100 cases,the length of abdominal cavity drainage tube indwelling time,postoperative hospital stay and total hospital stay time was 5 - 46 d (mean,14.4 ± 6.4 d),6 - 46 d (mean,18.3 ± 6.4 d),and 15 - 62 d (mean,27.1 ± 7.8 d),respectively. The rate of overall re-operation was 5.7% (6/105). Conclusion It is safe,reliable,and practical to place a stenting tube and perform end-to-side pancreaticojejunostomy with pancreatic duct-jejunum mucosa-mucosal doublelayer continuous suture in LPD.
来源 中国微创外科杂志 ,2019,19(6):485-489 【扩展库】
DOI 10.3969/j.issn.1009-6604.2019.06.002
关键词 腹腔镜胰十二指肠切除术 ; 胰腺空肠吻合术 ; 双层连续缝合
地址

兰州大学第二医院微创外科, 兰州, 730030

语种 中文
文献类型 研究性论文
ISSN 1009-6604
学科 外科学
基金 兰州大学第二医院萃英计划项目
文献收藏号 CSCD:6520977

参考文献 共 18 共1页

1.  中华医学会外科学分会胰腺外科学组. 腹腔镜胰十二指肠切除手术专家共识(附:手术流程与主要步骤). 中华外科杂志,2017,55(5):335-339 被引 35 次    
2.  Wente M N. Postpancreatectomy hemorrhage(PPH ): an International Study Group of Pancreatic Surgery(ISGPS) definition. Surgery,2007,142(1):20-25 被引 143 次    
3.  Bassi C. The 2016 update of the International Study Group (ISGPS ) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery,2017,161(3):584-591 被引 239 次    
4.  Wente M N. Delayed gastric emptying(DGE ) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery,2007,142(5):761-768 被引 154 次    
5.  Koch M. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the International Study Group of Liver Surgery. Surgery,2011,149(5):680-688 被引 98 次    
6.  Pugalenthi A. Postoperative complications and overall survival after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol,2016,113(2):188-193 被引 14 次    
7.  Mcmillan M T. Risk-adjusted outcomes of clinically relevant pancreatic fistula following pancreatoduodenectomy: a model for performance evaluation. Ann Surg,2016,264(2):344 被引 11 次    
8.  Shrikhande S V. Pancreatic anastomosis after pancreatoduodenectomy: a position statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery,2017,161(5):1221 被引 21 次    
9.  Cheng Y. Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction for the prevention of postoperative pancreatic fistula following pancreaticoduodenectomy. Cochrane Database Syst Rev,2017,9(6):CD012257 被引 5 次    
10.  吴志明. 腹腔镜胰体尾切除术后胰漏的防治进展. 中国微创外科杂志,2016,16(6):566-569 被引 3 次    
11.  Keck T. Pancreatogastrostomy Versus Pancreatojejunostomy for RECOnstruction After PANCreatoduodenectomy (RECOPANC, DRKS 00000767 ): perioperative and long-term results of a multicenter randomized controlled trial. Ann Surg,2016,263(3):440-449 被引 12 次    
12.  Topal B. Pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy for pancreatic or periampullary tumours: a multicentre randomised trial. Lancet Oncol,2013,14(7):655-662 被引 24 次    
13.  邹仲之. 组织学与胚胎学 (第8版),2013:148-150 被引 1 次    
14.  Bin X. Comparison of patient outcomes with and without stenting tube in pancreaticoduodenectomy. J Int Med Res,2018,46(1):403-410 被引 1 次    
15.  Suzuki S. Pancreaticoduodenectomies with a duct-to-mucosa pancreaticojejunostomy anastomosis with and without a stenting tube showed no differences in long-term follow-up. J Hepatobiliary Pancreat Sci,2011,18(2):258-262 被引 6 次    
16.  Mari G. Small bowel perforation caused by pancreaticojejunal anastomotic stent migration after pancreaticoduodenectomy for periampullary carcinoma. JOP,2015,16(2):185-188 被引 3 次    
17.  Park S H. Migration of internal pancreaticojejunostomy stents into the bile ducts in patients undergoing pancreatoduodenectomy. J Gastrointest Surg,2015,19(11):1995-2002 被引 4 次    
18.  王振勇. 腹腔镜胰十二指肠切除术后胰漏的相关因素分析. 中国微创外科杂志,2019,19(2):106-110 被引 3 次    
引证文献 2 篇

1 徐刚 腹腔镜胰十二指肠切除术胰管对空肠黏膜的胰肠吻合技巧 中国微创外科杂志,2020,20(6):573-576
被引 0 次

2 李庆斌 腹腔镜胰十二指肠切除术中胰肠吻合术式分析 中华肝胆外科杂志,2023,29(2):155-160
被引 0 次

显示所有2篇文献

论文科学数据集
PlumX Metrics
相关文献

 作者相关
 关键词相关
 参考文献相关

版权所有 ©2008 中国科学院文献情报中心 制作维护：中国科学院文献情报中心
地址：北京中关村北四环西路33号 邮政编码：100190 联系电话：(010)82627496 E-mail:cscd@mail.las.ac.cn 京ICP备05002861号-4 | 京公网安备11010802043238号