Pancreaticojejunostomy Sleeve Reconstruction after Pancreaticoduodenectomy in Laparoscopic and Open

来源 :2017第十九届中国科协年会 | 被引量 : 0次 | 上传用户:jijibabajiji
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
  Introduction: Laparoscopic procedures for pancreatic surgery have been significantly improved recently; however,only a limited number of successful laparoscopic or laparoscopy-assisted pancreaticoduodenectomy (PD) have been reported.The limitations could be attributed to the complexity of the reconstruction procedures under laparoscopic observation and the high incidence of complications.Postoperative pancreatic fistula (POPF) has been regarded traditionally as the most frequent major complication and is a potentially serious and life-threatening event.It remains the single most important cause of morbidity after PD and contributes significantly to prolonged mortality.Several modified methods of pancreas anastomosis were introduced to prevent POPF.However,few methods with a satisfactory leakage rate have yet to be seen.Collating principle of theoretical mechanics,we introduce a new method of reconstruction by performing an asymmetric sleeving-joint pancreaticojejunostomy (SJPJ).The aim of this study is to summarize the results of a new technique that is designed to decrease the POPF.Methods: From January 2004 to December 2010,SJPJ was performed on 86 patients undergoing PD by 1 surgeon: a laparoscopic reconstruction was completed in 9 cases,a hand-assisted laparoscopic reconstruction in 2 cases,and an open SJPJ reconstruction in 75 cases.Discussion: We used SJPJ,an asymmetric pancreaticojejunostomy (PJ).The time of operation ranged from 300 minutes to 640 minutes.Postoperatively there were no major morbidities and no deaths.Although POPF was observed in the laparoscopic SJPJ group with pancreatic adenocarcinoma,3 patients developed POPF in the open SJPJ group with ampullary adenocarcinoma (n1) and pancreatic adenocarcinoma (n2).The POPF rate was 9.30% in the open SJPJ group and 9.10% in the laparoscopic SJPJ group.The SJPJ procedure facilitates PJ,both laparoscopically and in open surgery.It is safe,effective,and feasible in experience hands.
其他文献
本文针对项目资金管理中经常出现的资金缺口大、资金集中率低等问题进行了全方位的剖析,并建立项目资金管理模型,提出了“全员参与、提高意识、合理预算、强化考核”的管理模
  有机催化聚合对可降解脂肪族聚酯在生物医药、微电子等领域中的应用意义重大,并逐渐成为脂肪族聚酯合成领域的发展方向。磷腈作为一类有机碱催化剂,生物相容性好,在酯类开环
会议
现阶段,我国已具备较为完善的市场经济体制,这对建筑行业的发展提供了有利条件,经济管理在建筑工程建设中尤为关键,借助经济管理可以有效提高企业的经济效益和工程建设的水平
本文通过调查四川省综合医改示范县14家县级公立医院卫生人力资源配置投入等情况,从中发现对经济运行的影响和存在的问题,探讨增强医院经济运行能力,调整收支结构的方式方法,
  本文报告了制备聚乙烯基吡咯烷酮-聚己内酯(PVP-PCL)嵌段共聚物胶束纳米载体及对抗癌药物紫杉醇的负载,研究了该药物传输体系的体内体外抗肿瘤效果,并研究了不同PVP链长对
促进京津冀协调发展是一项重大的国家战略,其核心是北京无资本功能的有序缓解,在京津冀交通一体化,生态保护,产业升级和搬迁等关键领域取得突破.而技术转移则是实现京津冀协
  Background: Increasing evidences demonstrate that miRNAs contribute to development and progression of hepatocellular carcinoma (HCC).Underexpression of miR-
会议
  作为纺织产业重要的基础原材料,通用聚合物纤维正不断拓展产品内涵和应用范围。针对通用聚合物纤维面临的同质化竞争严重、功能化纤维稳定性差和产业创新能力弱的不足,本文
马星野是我国新闻史上的重要人物,一生参与新闻事业60余年,其新闻实践和思想对当时及后世产生了重要而深刻的影响.在重庆图书馆从事整理民国文献工作的过程中,作者发现了有关
  随着全球无线通信技术和互联网技术的蓬勃发展,移动用户数量呈现爆炸式增长,各种移动新业务不断涌现。未来的5G移动通信系统不仅需要支持语音功能,还必须支持数字、图像
会议