膵頭十二指腸切除術における膵胃吻合による再建法

概要

論文の詳細を見る
膵頭十二指腸切除後の再建に対してWaughらが報告した膵胃吻合を行い，さらに二つの自動縫合器を用い二重器械吻合によるBillroth Ⅰ方式の胃空腸吻合を試みた．本術式では膵と胃が良好な位置で容易且つ確実に短時間で吻合できる．また膵液が活性化されないpH 酸性の胃内腔に排出されるため，膵と消化管との吻合に伴う膵痩，膿瘍など術後合併症の発生がきわめて少ない．膵頭部癌，下部胆管癌，慢性膵炎の6例に応用したので，手術成績を報告し考察を加えた．Since performed by Whipple in 1935, pancreaticoduodenectomy has become a standard operation for carcinoma of the head of the pancreas. Various operative methodes have been reported for reconstruction of the digestive tract. Because of the pancreatic fistula is the most common postoperative complication and main causes of operative death, attention has been directed mainly to the care of the resected pancreatic stump. Pancreaticogastrotomy in place of pancreaticojejunostomy reported by Waugh for the first time in 1946 is an alternative methode of restoring pancreaticointestinal continuity. It has been used the simple methde combined with gastrojejunostomy using EEA stapler after pancreaticoduodenectomy for carcinoma of the pancreas and chronic pancreatitis and is evaluated in this article.
1989-03-31