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find Keyword "吻合口出血" 2 results
  • Correlation Study of Pancreatic Leakage and Anastomotic Bleeding in Pancreaticojejunostomy after Pancreaticoduodenectomy

    Objective To analyze the difference in the incidence of postoperative pancreatic leakage and anasto-motic bleeding complications in various methods of pancreaticojejunostomy after pancreaticoduodenectomy (PD). Methods The clinical data of 526 patients underwent pancreaticojejunostomy from January 2008 to September 2012 in this hospital were analyzed retrospectively. End-to-side “pancreatic duct to jejunum mucosa-to-mucosa” anastomosis (abbreviation:mucosa-to-mucosa anastomosis) was performed in 359 patients, which contained 149 patients with internal drainage, 130 patients with external drainage, and 80 patients with no drainage. End-to-side invaginated anastomosis was performedin 165 patients without drainage. In addition, side-to-side anastomosis was performed in 2 patients without drainage.Results There were 34 cases (6.46%) of pancreatic leakage, 8 cases (1.52%) of anastomotic bleeding in pancreaticoje-junostomy, and 32 cases of death (6.08%). ① The pancreatic leakage rate of mucosa-to-mucosa anastomosis was signi-ficantly lower than that of end-to-side invaginated anastomosis 〔4.18% (15/359) versus 11.52% (19/165), χ2=10.029, P=0.002〕. There was no significant difference of the anastomotic bleeding incidence between mucosa-to-mucosa anasto-mosis and end-to-side invaginated anastomosis 〔1.67% (6/359) versus 1.21% (2/165), χ2=0.159, P=0.691〕. ② In the mucosa-to-mucosa anastomosis group, the pancreatic leakage rates in the ones with internal drainage and external drainage were lower than those in the ones without drainage, respectively (2.68% (4/149) versus 11.25% (9/80), χ2=7.132, P=0.008;1.54% (2/130) versus 11.25% (9/80), χ2=9.410, P=0.002);which was no significant difference between the ones with internal drainage and external drainage 〔2.68% (4/149) versus 1.54% (2/130), χ2=0.433, P=0.510〕. But there were no significant differences for both the pancreatic leakage 〔2.68% (4/149) versus 1.54% (2/130), χ2=0.433, P=0.510〕and anastomotic bleeding incidence 〔2.68% (4/149) versus 1.54% (2/130), χ2=0.433, P=0.510〕 between the ones with internal drainage and external drainage. Conclusions Mucosa-to-mucosa anastomosis has a lower pancreatic leakage incidence as compared with end-to-side invaginated anastomosis. However, there is no significant difference of the anast-omotic bleeding incidence. Internal or external drainage could reduce the incidence of pancreatic leakage, but have no obvious effect to the anastomotic bleeding incidence.

    Release date:2016-09-08 10:34 Export PDF Favorites Scan
  • 急诊内镜下止血夹治疗消化道机械吻合术后早期吻合口出血的疗效

    目的 探讨急诊内镜下使用止血夹治疗消化道机械吻合术后早期吻合口出血的疗效。 方法 回顾性分析 2005 年 1 月至 2016 年 12 月期间在笔者所在医院胃肠外科接受内镜下止血的 12 例消化道机械吻合术后早期吻合口出血患者的临床资料。 结果 本组 12 例患者中,10 例患者一次止血成功;2 例出现再次出血,其中 1 例再次内镜下止血成功,1 例胃空肠吻合术后患者止血失败、行手术治疗。所有患者术后均未出现吻合口漏等严重并发症。术后 11 例内镜止血成功患者获访 6~28 个月,中位随访时间 18 个月,随访期间未见再次出血。 结论 急诊内镜下止血夹治疗消化道机械吻合术后早期吻合口出血的操作简单、安全及有效,可作为首选方法在临床上推广应用。

    Release date:2017-09-18 04:11 Export PDF Favorites Scan
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