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作者在30例保留幽门的胰十二指肠切除术中,对手术细节上作了改进。胰腺空肠吻合时可很顺利地将胰腺套入空肠,胰管内放置长的内支撑引流管行肠腔内引流;胆道空肠吻合采用人工合成可吸收线连续单层吻合;胆道内不放置T型引流管,可避免术后胰液、胆汁丢失,从而稳定内环境。本组无胰痿发生。经胃窦放置高位空肠营养造痿管,可明显降低术后胃排空障碍。
The authors improved the details of surgery in 30 cases of pylorus-preserving pancreatoduodenectomy. When the pancreatic jejunal anastomosis can smoothly insert the pancreas into the jejunum, a long internal support drainage tube is placed in the pancreatic duct for intra-intestinal drainage; biliary jejunal anastomosis is performed using a synthetic absorbable wire for continuous single-layer anastomosis; T-type drainage is not placed in the biliary tract. The tube can avoid the loss of pancreatic fluid and bile after surgery and stabilize the internal environment. No pancreatic fistula occurred in this group. The placement of high jejunotrophic fistulas in the antrum can significantly reduce postoperative gastric emptying.