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ID:33392908
大小:1.22 MB
页数:24页
时间:2019-02-25
《胰十二指肠切除胰管空肠吻合对术后胰瘘发生率的影响》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、中文摘要流出体外,大大降低了肠腔内的压力和胰酶被激活时对吻合口的消化腐蚀作用。③胰腺残端未暴露于肠腔内,无胰酶对胰肠吻合的消化作用,从而减少了胰瘘的发生。胰肠吻合的方法虽然多种多样,但迄今尚无一种理想、安全的方法能够完全杜绝胰瘘的发生。每种吻合方法均有其自身优点,但同时也存在缺陷之处。不断改进胰肠吻合方式的目的就是要尽可能使胰肠吻合口具备良好的血供,紧密、牢固、无张力,从而有效降低胰肠吻合口瘘发生率。而采用何种吻合方法处理胰腺断端主要与术者的经验和习惯有直接关系,目前尚无公认的证据证明哪种吻合方法更优。关键词:胰十二指肠切除术;术后并发症;胰瘘;胰管空肠吻合;术式改进英文摘要TheImp
2、actofPancreaticoduodenectomyofPancreaticDuct1r●^』●JelUnUmAnaStom0SlS0nPostoperatiVePancreaticFistulaRateABSTRACTobjectiVe:1banalyzetheriskfactorsofpancreaticfistulaandpancreaticanastomosiswaytheincidenceofpancreaticfistulabasedon1itera£ureandclinicaldataofhospitalpatientsaRerpancreatoduodenectomy
3、.Methods:Collectedthedataof45patientshaVeunderdonep孕ncreatoduodenectomyinFourthHospitalofHebeiMedicalUniVersity丘om1,Janu射y,2008toDecember,31,20lO.Theoperationperformedconsisted44standardpancreaticoduodenectoHly(SPD)and1pylomspreservingpancreaticoduodenectomy(PPPD).TheorderofthedigestiVetractrecon
4、Structionispancreaticojejunostomy,cholangioenterostomy,gastrointestinalanastomosisofmeChildMethod.Thewayofpancreaticductjejunumisendtosideanastomosisofjejunuminoperation.Anastomosis:MakearowofintemJptedsuturesbetweenposteriormarginofpancreaticstumpandjejunalserosaandmusclelayer,then1igationandfix
5、edwall.Pokeasmallholewhichisthes锄esizeaspancreaticductintheemptywall.Suturewitha_bsorba_blesuturebetweenpancreaticductandemp够如11一micknessintestinalwallaRerdisinfected,stanchedbleeding.,temporarilyl逗ated.Insertthedrainagetubeintopancreaticduct2—3cm,thenfixedinpancreatictissue.Insertthedrainagetube
6、intointestine.Suturel追ationbetweenpancreaticductandemptywallonebyone.Finally,intemJptedsuturebetWeenameriorpancreatic咖mpandJejunalserosaandmusclelayer.Thatpancreaticdrainagetubeint0thejejunumonlyisnamedintemaldrainage.Thatdrainageoutofthebodybytheintestinalperforationiscalledtheextemaldrainage.In
7、stalldrainagetubeWhichmjejunumtotheplacethatisnearbybilia巧-emericanaStomosis.AtthesametimebuiltaTtubeinthebileduct.’nlatcandrainagepancreaticjuiceandbileats锄etime.Thisstudy英文摘要included24intemaldrainage(53.3%),21extemal
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