双U套入荷包捆绑式胰肠吻合术在IV、V 型胰腺外伤中的应用
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陈梅福, Email: chen_meifu@126.com

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Application of double U-suture invaginated pancreaticojejunostomy with binding purse-string sutures in treatment of grade IV and V pancreatic injury
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    目的:探讨双U 套入荷包捆绑式胰肠吻合术在胰腺外伤中的应用价值。 方法:回顾性分析2011 年1 月—2015 年1 月收治的9 例IV、V 型胰腺外伤患者的临床资料。 结果:胰腺外伤IV 型7 例,其中5 例行胰头断端缝闭(U 形交锁+ 连续缝扎),双U 套入荷包捆绑式 胰体尾空肠Roux-en-Y 内引流术后治愈;2 例合并十二指肠碎裂伤行胰十二指肠切除术、双U 套入荷 包捆绑式胰肠吻合术后治愈。V 型患者2 例,均行胰十二指肠切除术、双U 套入荷包捆绑式胰肠吻合 术后治愈。全组患者术后均未出现胰瘘、吻合口出血等严重并发症。所有患者均获得随访,一般情况 良好,均无糖尿病、腹泻、消化不良等胰腺功能减退情况发生,无死亡。 结论:双U 套入荷包捆绑式胰肠吻合法在胰腺外伤手术中是可行的,能够有效的防止术后胰瘘的发生。

    Abstract:

    Objective: To determine the application value of using double U-suture invaginated pancreaticojejunostomy (PJ) with binding purse-string sutures in the treatment of pancreatic injury. Methods: The clinical data of 9 patients with grade IV and V pancreatic injury admitted from January 2011 to January 2015 were retrospectively analyzed. Results: Of the 7 patients with grade IV injury, 5 cases were cured by closure of the stump of the head of the pancreas (U type lock-stitch and continuous sutures), and double U-suture invaginated Roux-en-Y pancreaticojejunal internal drainage and binding purse-string sutures, and 2 cases with duodenal rupture were cured by pancreaticoduodenectomy (PD) and double U-suture invaginated PJ with binding purse-string sutures. Two patients with grade V pancreatic injury were both cured by PD and double U-suture invaginated PJ with binding purse-string sutures. No severe complications such as postoperative pancreatic fistula or anastomotic bleeding occurred in any of the 9 patients. All the patients were fellowed- up, and there were no diabetes, diarrhea or other complications, and no deaths. Conclusion: Double U-suture invaginated PJ with binding purse-string sutures is feasible in surgery for pancreatic injury, and it could effectively prevent the occurrence of postoperative pancreatic fistula.

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邹方,陈梅福,李国光,李云峰,罗骁.双U套入荷包捆绑式胰肠吻合术在IV、V 型胰腺外伤中的应用[J].中国普通外科杂志,2016,25(3):418-422.
DOI:10.3978/j. issn.1005-6947.2016.03.019

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  • 收稿日期:2015-09-22
  • 最后修改日期:2016-02-18
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  • 在线发布日期: 2016-03-15