Experience in application of pancreaticojejunostomy with double purse-string suture in laparoscopic pancreaticoduodenectomy
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摘要: 目的探讨完全腹腔镜胰十二指肠切除术中一种安全有效的胰肠吻合方式。方法回顾性分析吉林大学第一医院近期完成的6例完全腹腔镜胰十二指肠切除术的临床资料,分析采取双荷包缝合法的胰肠吻合方法在完全腹腔镜胰十二指肠切除术中的应用。结果 6例患者均顺利完成手术,平均手术时间317 min(260~370 min),其中胰肠吻合时间31 min(25~39 min),术中出血量125 ml(50~350 ml)。术后无出血,仅2例发生胰瘘,其中1例为A级胰瘘,自行愈合;1例为B级胰瘘,经治疗痊愈。结论双荷包缝合法的胰肠吻合方法可作为完全腹腔镜胰十二指肠切除术中安全、有效、快捷的胰肠吻合方式。Abstract: Objective To investigate double purse- string suture as a safe and effective method for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy. Methods A total of 6 patients who recently underwent laparoscopic pancreaticoduodenectomy in The First Hospital of Jilin University were enrolled. Their surgical methods and clinical data were analyzed retrospectively to analyze the application of double purse- string suture in laparoscopic pancreaticoduodenectomy. Results All the 6 patients completed the surgery successfully,and the mean time of operation was 317 min( range 260- 370 min). The mean time of pancreaticojejunostomy was 31 min( range 25- 39 min),and the mean intraoperative blood loss was 125 ml( range 50- 350 ml). There was no postoperative bleeding. Two patients experienced pancreatic leakage,among whom 1 experienced grade A pancreatic leakage which healed spontaneously,and the other patient experienced grade B pancreatic leakage which healed after treatment. Conclusion Double purse- string suture is a safe,effective,and convenient method for pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy.
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