摘要目的 研究胰体尾切除术中传统手工缝合和直线切割闭合器处理胰腺残端对术后并发症的影响.方法 回顾性分析2003年1月至2006年12月间109例接受胰体尾切除术患者的临床资料.结果 109例患者中53例患者在开腹手术中手工缝合封闭胰腺残端;56例患者使用直线切割闭合器切断并封闭胰腺组织,其中31例在开腹手术中使用直线切割闭合器,25例在腹腔镜手术中使用腹腔镜直线切割闭合器.直线切割闭合器组患者的术后胰瘘以及腹腔感染发生率分别为21.4%和8.9%,低于手工缝合组的41.5%和28.3%(P=0.024和P=0.009),但在手术持续时间、术后输血、术后再出血以及住院费用方面均无显著性差异.结论 使用切割闭合器可以降低术后腹腔感染和胰瘘发生率.

abstractsObjective To determine the influence of hand-sewn and stapler in distal pancreatectomy on the postoperative complication.Methods Clinical data of 109 patients after distal pancreatectomy from January 2003 to December 2006 were analyzed retrospectively.Results The surgical techniques used for closure of the pancreatic stump after distal pancreatectomy were categorized into hand sewn closure group(n=53)and stapler closure group(n=56).In stapler closure group,25 patients accepted laparoscopic operation.The incidences of abdominal infection and pancreatic fistulae in stapler closure group were lower than hand-sewn closure group.The operation time,blood infusion,postoperative bleeding and medical costs were similar between two groups.Conclusion Stapler closure in distal pancreatectomy could decrease the incidence of pancreatic fistula and abdominal infections.