涤纶垫片加强胰十二指肠切除术中胰肠吻合的初步临床研究
A preliminary clinical study of polyester spacer-enhanced pancreatico-intestinal anastomosis in pan-creaticoduodenectomy
李鑫 1王嘉毅 1李少华 2朱瑞利 2贾振飞 2马成云 2王现兵2
作者信息
- 1. 新乡医学院安阳市人民医院培养基地,安阳 455000
- 2. 安阳市人民医院肝胆胰外科,安阳 455000
- 折叠
摘要
目的 探讨将涤纶垫片用于加强传统胰十二指肠切除术中胰肠吻合,从而预防术后胰瘘的安全性与实用性.方法 回顾性分析2018年8月至2023年8月安阳市人民医院由同一主刀医师完成的82例胰十二指肠切除术的患者临床资料,其中男性52例,女性30例,年龄(62.21±9.75)岁.根据是否在胰肠吻合中使用涤纶垫片将患者分为试验组(n=40)与对照组(n=42),对两组的围术期数据进行比较,并利用Logistic分析影响术后胰瘘的危险因素.结果 两组患者在胆瘘、肠瘘、腹腔感染、腹腔出血、术后死亡率方面差异无统计学意义(均P＞0.05).试验组术后胰瘘发生率20.0％(8/40)低于对照组的45.2％(19/42),差异有统计学意义(P=0.015).胰腺质地较软(OR=16.595,95％CI:1.891-145.657)是发生术后胰瘘的独立危险因素,而使用涤纶垫片的改良胰肠吻合方式(OR=0.332,95％CI:0.114-0.969)可降低发生术后胰瘘的风险.结论 在胰十二指肠切除术中使用涤纶垫片加强胰肠吻合能降低术后胰瘘发生率,具有较好的安全性和实用性.
Abstract
Objective To investigate the safety and utility of using polyester spacers in conventional pancreatico-enteric anastomosis in pancreaticoduodenectomy to achieve prevention of postoperative pancreatic fistula.Methods The clinical data of 82 patients with pancreaticoduodenectomy completed by the same physician in Anyang People's Hospital from August 2018 to August 2023 were retrospectively analyzed,inclu-ding 52 males and 30 females,aged(62.21±9.75)years.They were divided into two groups,test group(n=40)and control group(n=42)according to whether polyester spacers were used in pancreatico-intestinal anastomosis,the perioperative data of the two groups were compared,and Logistic analysis was used to ana-lyze the risk factors affecting postoperative pancreatic fistula.Results There was no statistically significant difference between the two groups in terms of biliary fistula,intestinal fistula,abdominal infection,abdomi-nal bleeding,and postoperative mortality rate(all P＞0.05).The incidence of postoperative pancreatic fis-tula in the test group was 20.0％(8/40)which was lower than that in the control group 45.2％(19/42),and the difference was statistically significant(P=0.015).Soft pancreas texture(OR=16.595,95％CI:1.891～145.657)was an independent risk factor for postoperative pancreatic fistula,while improved pan-creatic enterostomy with polyester spacers(OR=0.332,95％CI:0.114～0.969)could reduce the risk of postoperative pancreatic fistula.Conclusion Use of polyester spacers to reinforce the pancreatico-enteric anastomosis during pancreaticoduodenectomy reduces the incidence of postoperative pancreatic fistulae with good safety and practicality.
关键词
胰十二指肠切除术/胰肠吻合/涤纶垫片/胰瘘Key words
Pancreaticoduodenectomy/Pancreaticojejunostomy/Polyester gasket/Pancreatic fistula引用本文复制引用
基金项目
河南省科技攻关-联合共建项目(LHGJ20191275)
出版年
2024
NETL
NSTL
万方数据