2020 年第 1 期 第 15 卷

胰腺残端捆绑式结扎法在胰体尾切除术中的临床应用研究

Clinical observation of bundle ligation of pancreatic stump in distal pancreatectomy

作者：熊伟1董科1俞小炯1古春1杨勇2

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关键词：胰体尾切除术；胰瘘；胰腺残端捆绑式结扎

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• 摘要：

• 【摘要】目的    探讨胰腺残端捆绑式结扎法在胰体尾切除术（DP）中的安全性、实用性和有效性。方法    回顾性分析2015年1月至2018年12月在四川省人民医院行DP的90例患者的病历资料，依据胰腺残端处理方式不同分为A组(常规缝合组)和B组(捆绑式结扎组)，各45例。比较2种胰腺残端处理方式对术后胰瘘及其他并发症发生率的影响。结果    总体胰瘘发生率为16.7%（15/90），A组和B组胰瘘发生率分别为28.9%(13/45)和4.4%（2/45)，组间差异有统计学意义(P＜0.01)。B组术中出血量、腹腔引流量明显少于A组［（256±157）ml比（367±163）ml、（116±80）ml比（255±75）ml］，差异均有统计学意义(均P＜0.01)。2组其他并发症发生率差异均无统计学意义(均P＞0.05)。结论    胰腺残端捆绑式结扎法能明显降低胰体尾切除术后胰瘘发生率，该术式安全、实用、有效。

• 【Abstract】Objective    To analyze the safety, practicability and effectiveness of bundle ligation of pancreatic stump in distal pancreatectomy(DP). Methods    Ninety patients who underwent DP in Sichuan Provincial People′s Hospital from January 2015 to December 2018 were retrospectively analyzed; 45 patients were treated with routine suture(group A) and 45 patients were treated with bundle ligation of pancreatic stump(group B). Incidences of postoperative pancreatic fistula and other complications were analyzed. Results    The overall incidence rate of pancreatic fistula was 16.7%（15/90）. Incidence rates of pancreatic fistula in group A and group B were 28.9%(13/45) and 4.4%（2/45), with significant difference between groups(P＜0.01). Intraoperative blood loss and abdominal drainage volume in group B were significantly less than those in group A［（256±157）ml vs （367±163）ml, （116±80）ml vs （255±75）ml］(both P＜0.01). Incidence rate of other complications showed no obvious difference between groups(P＞0.05). Conclusion    Bundle ligation of pancreatic stump can significantly reduce the incidence of pancreatic fistula after distal pancreatectomy.