一种新型胰腺空肠吻合方法——空肠浆肌层鞘捆扎法.pdfVIP

主国塑 主 芏苤查 Z生! 旦箜!!鲞箜鱼塑 40l [文章编号]1009—2188(2007)06—0401—04 · 术 式 介 绍 与 探 讨 · 一 种新型胰腺空肠吻合方法 空肠浆肌层鞘捆扎法 王群伟，刘威，戴卫东，陈卫东 (中南大学湘雅二医院普外科，长沙410011) [摘要] 目的 介绍一种改进的胰腺空肠端端吻合方法。 方法 首先将空肠断端去粘膜化后 形成浆肌层鞘，将胰腺断端和粘膜层进行第一层缝合。打结后将空肠浆肌层鞘套入胰腺断端，将胰腺断 端和浆肌层鞘进行第二层缝合，打结前将一根捆扎丝线在第二层缝线中间包绕胰腺套入部，再进行第二 层的打结，将空肠浆肌层鞘固定于胰腺上。最后将捆扎丝线打结，使浆肌层鞘和胰腺之间紧密相贴。临 床应用3例，均为胰头十二指肠切除术患者。 结果 胰腺空肠吻合时间分别为5，8，10 min，无胰漏发 生。 结论 空肠浆肌层鞘捆扎法简单易行，能缩短手术时间，初步结果显示无胰漏发生。 [关键词] 胰管空肠吻合术 [中图分类号]R657．5 [文献标识码]A A Novel Method of Pancreaticojejunostomy·invagination into Demucosalized Jejunal End、vith Binding WANG Qu．一wei，LIU Wei，DAI Wei一66D ，CHEN Wei一66D (Department ofGeneral Surgery，Second Xiangya Hospital，Central South Unive~iq，Changsha 410011，Hunan，China) Abstract： Objective To introduce a novel method of pancreaticojejunostomy． Methods A ring of mucosa in length of 1．5cm was removed in the jejunal end to create a session of demucosalized jejunal loop，four stitches were undeflaken between the pancreatic stump and the mucosa ending of jqunum to complete the inner layer of anastomosis，then the pancreatic stump Was subsequently invaginated into the demucosalized jejunal end after the stitches were tied．The outer layer of the anastomosis were conducted between the pancreas and the sero- muscular layer with another four stitches，and a silk tie Was placed around the jejunal end between the untied two wings of the four stitches．Four stitches were tied firstly to guarantee the demucosalized loop fi~e3 safely followed by tying of the silk suture to ensure a non—leaking attaching of the demucosalized loop onto the pancreas．There were 3 cases undergone this novel method to conduct the pancreaticojejunostomy during the Whipple~procedure for their periampular malignancies． Result It took 5，8，and 10 minutes to perform the anastomosis in 3 cases， respectively，and no pan