• 1.同濟大學(xué)附屬同濟醫(yī)院普外科（上海200065）;;
  • 2.上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院普外科(上海200025);

目的 　探討胰十二指腸切除術(shù)中采用胰胃吻合重建胰腺殘端的手術(shù)指征及療效。
方法 　回顧性分析上海同濟醫(yī)院2005年8月至2008年2月期間施行的胰十二指腸切除并行胰胃吻合的38例患者的臨床資料。
結(jié)果 　本組患者均順利完成手術(shù)，平均手術(shù)時間(352.1±78.3) min, 術(shù)中平均輸血量(911.3±601.4) ml； 術(shù)后住院時間平均(26.2±12.1) d; 術(shù)后發(fā)生并發(fā)癥8例(21.1%)，其中胰瘺1例(2.6%)，胃排空障礙2例(5.3%)，切口感染2例(5.3%)，腹腔積液1例(2.6%)，肺部感染2例(5.3%)，均經(jīng)保守治療后痊愈，無住院手術(shù)死亡病例。
結(jié)論 　胰胃吻合是一種安全、可靠及有效的胰腺殘端重建方式，根據(jù)患者的具體情況合理地選擇胰胃吻合可以最大程度地減少胰十二指腸切除術(shù)后胰瘺的發(fā)生。

引用本文： 陳泉寧,彭承宏,范躍祖,韓寶三,程東峰. 胰胃吻合在胰十二指腸切除術(shù)中的應(yīng)用. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(3): 223-225. doi: 復(fù)制

1. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes [Ｊ]. Ann Surg, 1997; 226(3):248.
2. Beger HG, Gansauge F, Schwab M, et al. Pancreatic head resection: the risk for local and systemic complications in 1 315 patients—a monoinstitutional experience [Ｊ]. Am J Surg, 2007; 194:16.
3. Kleespies A, Albertsmeier M, Obeidat F, et al. The challenge of pancreatic anastomosis [Ｊ]. Langenbecks Arch Surg, 2008; 393(4):459.
4. Lermite E, Pessaux P, Brehant O, et al. Risk factors of pancreatic fistula and delayed gastric emptying after pancreaticoduodenectomy with pancreaticogastrostomy [Ｊ]. J Am Coll Surg, 2007; 204(4):588.
5. Tran K, Van Eijck C, Di Carlo V, et al. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial [Ｊ]. Ann Surg, 2002; 236(4):422.
6. Schlitt HJ, Schmidt U, Simunec D, et al. Morbidity and mortality associated with pancreatogastrostomy and pancreatojejunostomy following partial pancreatoduodenectomy [Ｊ]. Br J Surg, 2002; 89(10):1245.
7. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(4):580.
8. Aranha GV, Hodul P, Golts E, et al. A comparison of pancreaticogastrostomy and pancreaticojejunostomy following pancreaticoduodenectomy [Ｊ]. J Gastrointest Surg, 2003; 7(5):672.
9. Bassi C, Falconi M, Molinari E, et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study [Ｊ]. Ann Surg, 2005; 242(6):767.
10. McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(8):929.
11. 王建玲, 王強, 田志龍. 胰十二指腸切除術(shù)的單層胰胃吻合 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2001; 8(6):416.
12. 劉海, 馬勇, 任祖海. 胰腺-胃吻合術(shù)在胰十二指腸切除術(shù)中的應(yīng)用(附24例報告) [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(2):210.
13. Tripodi AM, Sherwin CF. Experimental transplantation of the pancreas into the stomach [Ｊ]. Arch Surg, 1934; 28:345.
14. Waugh JM, Clagett OT. Resection of the duodenum and head of pancreas for carcinoma. An analysis of thirty cases [Ｊ]. Surgery, 1946; 20:224.
15. 〖JP2〗Shinchi H, Takao S, Maemura K, et al. A new technique for pancreaticogastrostomy for the soft pancreas: the transfixing suture method [Ｊ]. J Hepatobiliary Pancreat Surg, 2006; 13(3):212〖JP〗.
16. Aranha GV. A technique for pancreaticogastrostomy [Ｊ]. Am J Surg, 1998; 175(4):328.
17. Takano S, Ito Y, Watanabe Y, et al. Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2000; 87(4):423.
18. Takao S, Shimazu H, Maenohara S, et al. Modified pancreaticogastrostomy following pancreaticoduodenectomy [Ｊ]. Am J Surg, 1993; 165(3):317.
19. Payne RF, Pain JA. Duct-to-mucosa pancreaticogastrostomy is a safe anastomosis following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(1):73.
20. Murakami Y, Uemura K, Hayashidani Y, et al. No mortality after 150 consecutive pancreatoduodenctomies with duct-to-mucosa pancreaticogastrostomy [Ｊ]. J Surg Oncol, 2008; 97(3):205.
  1. 1. Yeo CJ, Cameron JL, Sohn TA, et al. Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes [Ｊ]. Ann Surg, 1997; 226(3):248.
  2. 2. Beger HG, Gansauge F, Schwab M, et al. Pancreatic head resection: the risk for local and systemic complications in 1 315 patients—a monoinstitutional experience [Ｊ]. Am J Surg, 2007; 194:16.
  3. 3. Kleespies A, Albertsmeier M, Obeidat F, et al. The challenge of pancreatic anastomosis [Ｊ]. Langenbecks Arch Surg, 2008; 393(4):459.
  4. 4. Lermite E, Pessaux P, Brehant O, et al. Risk factors of pancreatic fistula and delayed gastric emptying after pancreaticoduodenectomy with pancreaticogastrostomy [Ｊ]. J Am Coll Surg, 2007; 204(4):588.
  5. 5. Tran K, Van Eijck C, Di Carlo V, et al. Occlusion of the pancreatic duct versus pancreaticojejunostomy: a prospective randomized trial [Ｊ]. Ann Surg, 2002; 236(4):422.
  6. 6. Schlitt HJ, Schmidt U, Simunec D, et al. Morbidity and mortality associated with pancreatogastrostomy and pancreatojejunostomy following partial pancreatoduodenectomy [Ｊ]. Br J Surg, 2002; 89(10):1245.
  7. 7. Yeo CJ, Cameron JL, Maher MM, et al. A prospective randomized trial of pancreaticogastrostomy versus pancreaticojejunostomy after pancreaticoduodenectomy [Ｊ]. Ann Surg, 1995; 222(4):580.
  8. 8. Aranha GV, Hodul P, Golts E, et al. A comparison of pancreaticogastrostomy and pancreaticojejunostomy following pancreaticoduodenectomy [Ｊ]. J Gastrointest Surg, 2003; 7(5):672.
  9. 9. Bassi C, Falconi M, Molinari E, et al. Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy: results of a comparative study [Ｊ]. Ann Surg, 2005; 242(6):767.
  10. 10. McKay A, Mackenzie S, Sutherland FR, et al. Meta-analysis of pancreaticojejunostomy versus pancreaticogastrostomy reconstruction after pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(8):929.
  11. 11. 王建玲, 王強, 田志龍. 胰十二指腸切除術(shù)的單層胰胃吻合 [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2001; 8(6):416.
  12. 12. 劉海, 馬勇, 任祖海. 胰腺-胃吻合術(shù)在胰十二指腸切除術(shù)中的應(yīng)用(附24例報告) [Ｊ]. 中國普外基礎(chǔ)與臨床雜志, 2007; 14(2):210.
  13. 13. Tripodi AM, Sherwin CF. Experimental transplantation of the pancreas into the stomach [Ｊ]. Arch Surg, 1934; 28:345.
  14. 14. Waugh JM, Clagett OT. Resection of the duodenum and head of pancreas for carcinoma. An analysis of thirty cases [Ｊ]. Surgery, 1946; 20:224.
  15. 15. 〖JP2〗Shinchi H, Takao S, Maemura K, et al. A new technique for pancreaticogastrostomy for the soft pancreas: the transfixing suture method [Ｊ]. J Hepatobiliary Pancreat Surg, 2006; 13(3):212〖JP〗.
  16. 16. Aranha GV. A technique for pancreaticogastrostomy [Ｊ]. Am J Surg, 1998; 175(4):328.
  17. 17. Takano S, Ito Y, Watanabe Y, et al. Pancreaticojejunostomy versus pancreaticogastrostomy in reconstruction following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2000; 87(4):423.
  18. 18. Takao S, Shimazu H, Maenohara S, et al. Modified pancreaticogastrostomy following pancreaticoduodenectomy [Ｊ]. Am J Surg, 1993; 165(3):317.
  19. 19. Payne RF, Pain JA. Duct-to-mucosa pancreaticogastrostomy is a safe anastomosis following pancreaticoduodenectomy [Ｊ]. Br J Surg, 2006; 93(1):73.
  20. 20. Murakami Y, Uemura K, Hayashidani Y, et al. No mortality after 150 consecutive pancreatoduodenctomies with duct-to-mucosa pancreaticogastrostomy [Ｊ]. J Surg Oncol, 2008; 97(3):205.