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首页> 外文期刊>Journal of hepato-biliary-pancreatic surgery >Prospective randomized pilot trial comparing closed suction drainage and gravity drainage of the pancreatic duct in pancreaticojejunostomy.
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Prospective randomized pilot trial comparing closed suction drainage and gravity drainage of the pancreatic duct in pancreaticojejunostomy.

机译：前瞻性随机试验比较了胰空肠造口术中胰管的闭合吸引引流和重力引流。

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BACKGROUND: Pancreaticojejunal anastomotic leakage remains a major complication after pancreatoduodenectomy, and various means of preventing pancreatic leakage have been studied over the past few decades. The purpose of this study was to determine whether closed suction drainage provided a better option than gravity drainage in pancreaticojejunostomy. METHODS: Between 2004 and 2006, a total of 110 patients who underwent pancreaticojejunostomy at our institute were enrolled in this prospective randomized pilot study. Fifty-five patients were allocated to the closed suction drainage (CD) group and 55 to the gravity drainage (GD) group. In each patient a polyethylene pediatric feeding tube was inserted into the remnant pancreatic duct across a duct-to-mucosa type pancreaticojejunostomy and totally externalized. The tube was then connected to the aspiration bag of a Jackson-Pratt drain to generate negative pressure or to a bile bag for natural drainage. Pancreatic fistulas were defined and graded as A, B, or C according to the international study group for pancreatic fistulas (ISGPF) criteria. RESULTS: No differences were found between the GD and CD groups in age, sex distribution, or diagnosis. A pancreatic fistula occurred in 24 patients (43.6%) in the GD group and in 14 (25.5%) in the CD group (P = 0.045). In the GD group, grade B and C fistula occurred in 6 patients (10.9%), whereas in the CD group, this occurred in 5 patients (9.1%). CONCLUSION: In this study, temporary external drainage of the pancreatic duct with closed suction drainage significantly reduced the incidence of grade A pancreatic fistula. A follow-up randomized prospective multicenter study has been initiated.
机译：背景：胰空肠吻合口漏仍然是胰十二指肠切除术后的主要并发症，并且在过去的几十年中已经研究了各种预防胰漏的方法。这项研究的目的是确定在胰空肠造口术中，封闭吸引引流是否比重力引流提供更好的选择。方法：在2004年至2006年期间，本研究所共有110例行胰空肠吻合术的患者参加了这项前瞻性随机试验研究。五十五名患者被分配到闭式引流（CD）组，55名被分配到重力引流（GD）组。在每位患者中，将聚乙烯小儿饲管穿过导管-粘膜型胰空肠吻合术插入残存的胰管中，并完全外置。然后将试管连接至Jackson-Pratt引流管的抽吸袋以产生负压，或连接至自然引流的胆囊。根据国际胰瘘研究小组（ISGPF）的标准，将胰瘘定义为A，B或C。结果：GD组和CD组在年龄，性别分布或诊断上均无差异。 GD组有24例（43.6％）患者发生胰瘘，而CD组有14例（25.5％）患者发生胰瘘（P = 0.045）。在GD组中，B和C级瘘管发生在6例患者中（10.9％），而在CD组中，这发生在5例患者中（9.1％）。结论：在这项研究中，胰管的临时外部引流和闭合抽吸引流显着降低了A级胰腺瘘的发生率。一项后续的随机前瞻性多中心研究已经启动。

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