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目的探讨Child法改良技术在胰十二指肠切除术(PD)中的应用价值。方法把近5年胰头及壶腹周围癌患者随机分成2组,一组为Child法改良组(22例),一组为传统Child法对照组(17例),比较术后恢复及并发症情况。结果改良组术后3～5(平均4)天胃肠功能恢复,4～6(平均5)天后可通过营养管及经口进流食,5～7(平均6)天拔除腹腔引流管(除胰瘘外);仅1例术后发生小量胰瘘,1例发生碱性反流性胃炎;住院时间12～16(平均14)天。对照组术后5～7天胃肠功能恢复,6～8天后可通过营养管及经口进流食,22～40(平均31)天拔除T型管;切口感染1例,肠瘘1例;住院时间14～40(平均27)天。结论 Child法改良技术在PD中应用具有术后恢复快、腹腔引流和住院时间短等优点。
Objective To investigate the value of modified Child technique in pancreaticoduodenectomy (PD). Methods The patients with pancreatic cancer and periampullary carcinoma in the past 5 years were randomly divided into two groups. One group was modified by Child method (22 cases), the other was control group (17 cases) with traditional Child method. The postoperative recovery and complications Happening. Results In the improved group, the gastrointestinal function recovered 3 to 5 days (average 4) days after operation. After 4 to 6 days (average 5 days), the abdominal drainage tube was removed 5 to 7 days (mean 6 days) Pancreatic fistula); only a small amount of pancreatic fistula occurred in one case, alkaline reflux gastritis occurred in one case; the hospitalization time was 12 to 16 days (average 14 days). The control group recovered gastrointestinal function 5 to 7 days after operation. After 6 to 8 days, the T-tube was removed through the feeding tube and oral feeding, and the T-tube was removed from 22 to 40 (average 31) days. One case of incision infection and one case of intestinal fistula, Hospitalization time 14 ~ 40 (average 27) days. Conclusion The improved Child method has the advantages of rapid postoperative recovery, shortened abdominal drainage and hospitalization in PD.