@article{oai:kanazawa-u.repo.nii.ac.jp:00026815,
 author = {萱原, 正都 and 永川, 宅和 and 荒川, 元 and 八木, 治雄 and 二上, 文夫 and 長森, 正則 and 北川, 裕久 and 太田, 哲生 and 上野, 桂一 and 宮崎, 逸夫},
 issue = {4},
 journal = {日本消化器外科学会雑誌 = The Japanese journal of gastroenterological surgery},
 month = {Apr},
 note = {各種膵腸吻合法とその合併症ならびに腹腔内持続吸引ドレナージ法 (continuous intraabdominal suction drainage:CISD) の有用性について膵腸吻合143例 (膵頭部癌66例, 胆管癌40例, 乳頭部癌32例, 胆嚢癌5例) を対象に検討した. 膵嵌入 (l) 法が20例, 漿膜筋層切開膵管挿入 (ll) 法が22例, 非切開膵管挿入 (lll) 法が48例, 膵管空腸吻合 (lV) 法が53例であった. 膵液漏出はl, ll, lll, lV法でそれぞれ 20%, 21%, 0%, 13%, 縫合不全は 25%, 14%, 6%, 4% と lll, lV 法の成績が良好であった. 膵液漏出は胆道癌で 21%, 膵癌で 6%, 縫合不全はそれぞれ 14%, 5% と有意 (p<0.05) に膵癌で低率であった. 2か月以内の早期死亡は l, ll, lll, lV 法でそれぞれ 25%, 14%, 12%, 6% であり, lV 法で早期死亡が少なかった. また, CISD 未施行群では膵液漏出や縫合不全例で早期死亡が多かったが, CISD 施行群では膵液漏出, 縫合不全と早期死亡との相関はなかった. 以上より, 膵管空腸吻合法と CISD 法は膵空腸吻合法の合併症軽減に有用と考えられた. Complications after pancreato jejunostomy were investigated to the type of anastomosis, and the usefulness of continuous intraabdominal suction drainage (CISD) was evaluated. One hundred and forty three patients were included in this study. The invagination method (type l) was used in 20 patients, the duct-insertion method with seromyotomy (type ll) in 22, the duct-insertion method without seromyotomy (type lll) in 48, and pancreaticojejunostomy followed by total layer anastomosis (type lV) in 53. The incidence of pancreatic fistula was 20% in the type l group, 21% in type ll, 0% in type lll, and 13% in type lV. The incidence of anastomotic leakage was 25%, 14%, 6%, and 4%, respectively. There was a significant difference in the frequency of anastomotic leakage between pancreatic cancer and biliary tract cancer (5% in pancreatic cancer versus 14% biliary cancer). Postoperative early death occurred in 25% of the patients in the type l group, 14% in type ll, 12% in typr lll, 6% in type lV. There was a tendency toward a correlation between postoperative early death and anastomotic complications in the non-CISD group (p=0.06). However, there was no correlation between the two factors in CISD group. There results indicate that pancreaticojunostomy followed by total layer anastomosis and CISD are useful and safe procedures after pancreaticoduodenectomy.},
 pages = {853--857},
 title = {教室における各種膵腸吻合法の合併症に関する一考察},
 volume = {29},
 year = {1996}
}