目的 用保留十二指肠水平段的胰十二指肠切除术及Roux-Y同步吻合重建消化道的方法，达到降低手术并发症，促进患者恢复，提高其生存质量和时间。方法 在行胰十二指肠切除术时，保留十二指肠水平段、升段、屈氏韧带及空肠上段，用RouxY同步吻合的方法将胰、胆、胃、肠重建排列，术后胆肠吻合口不置T管及空肠不置造瘘管，腹腔置2 mm硅胶管用于灌洗。结果 28例中除2例切口裂开，行二期缝合外，均顺利恢复出院。平均住院25天。无胆、胰漏，无返流性胆管、胰管炎等。随访6个月~6年，1年生存24例（85.7%），3年生存15例（53.6%），5年生存5例（17.9%）。结论 保留十二指肠水平段，消化功能恢复快，不影响根治时相关淋巴结的廓清。用Roux-Y同步吻合重建消化道，并发症少。不置T管和空肠造瘘管，对患者侵扰小，恢复快，提高了患者生存率。
摘要:目的: 探讨自发性食管破裂的诊断和治疗经验。 方法 :对我院1996年2月至2009年8月收治的8例自发性食管破裂患者的诊断和治疗作回顾性分析。 结果 :全组患者7例行手术治疗,1例行保守治疗。6例患者行修补手术,其中4例行分层缝合,2例行全层缝合。1例行食管切除胃食管吻合术。本组痊愈7例,死亡1例。 结论 :早期诊断和早期治疗是自发性食管破裂的治疗原则。确诊患者,若病情允许,应首选手术治疗。Abstract: Objective: To explore the clinical diagnosis and treatment of spontaneous esophageal rupture. Methods :The clinical features, diagnosis and surgical treatment of 8 patients with spontaneous esophageal rupture were retrospectively reviewed. Results :There were 7 cases treated by surgical therapy and 1 case for conservative treatment. 6 cases were treated by surgical repair including 4 cases of layered suture and 2 cases of singlelayer suture. 1 case was treated by esophagus resection and gastroesophagostomy. In the whole group, 7 cases were cured and 1 case died. Conclusion :The therapeutic principle of spontaneous esophageal rupture are early diagnosis and early treatment. For diagnosed patient, surgical procedure is the first choice if condition permitted.