探究改良胰管-空肠桥式导管内引流在腹腔镜胰十二指肠切除术中的应用效果。

采取前瞻性研究，纳入2021年1月至2023年5月接受腹腔镜胰十二指肠切除术（LPD）的95例患者，采用随机数字表法分为改良组和对照组。改良组48例应用改良胰管-空肠桥式导管内引流，对照组47例行传统胰管-空肠黏膜吻合（含内引流）。术中出血量、手术时间、住院时间等计量资料用（±s）表示，行独立样本t检验；等级资料或计数资料如术后并发症总发生率、Clavien-Dindo并发症分级以率表示，行秩和检验或χ²检验。以Kaplan-Meier绘制生存分析曲线，Log-Rank检验比较两组间生存差异。

两组患者术中输血量、住院费用相比，差异无统计学意义（P>0.05）；改良组与对照组患者累积总生存率相比，差异无统计学意义（100.0% vs. 95.7%，Log-Rank χ²=1.887，P>0.05）；与对照组相比，改良组患者术中出血量更少、手术时间、引流管留置时间、吻合时间与住院时间更短，术后第1天引流液淀粉酶水平更低（P<0.05）；改良组患者术后并发症总发生率、Clavien-Dindo Ⅰ-Ⅲ并发症分级均低于对照组（4.2% vs. 27.7%，P<0.05）。改良组B/C级CR-POPF发生率为2.1%（1/48），显著低于对照组的17.0%（8/47）（P<0.05）。

在LPD中，改良胰管-空肠桥式导管内引流优化了吻合操作，缩短了手术、吻合与住院时间，减少术中出血，术后并发症发生风险更低，相较于传统胰管-空肠黏膜吻合(含内引流)更安全高效。

To explore the application effect of modified pancreatic duct-jejunum bridge-type internal drainage in laparoscopic pancreaticoduodenectomy (LPD).

This study adopted a prospective design, enrolling 95 patients who underwent LPD from January 2021 to May 2023. Patients were divided into two groups using a random number table: 48 cases in the modified group received modified pancreatic duct-jejunum bridge-type internal drainage, and 47 cases in the control group underwent traditional pancreatic duct-jejunum mucosa anastomosis (including internal drainage). Measurement data such as intraoperative blood loss, operation time, and hospital stay were expressed as (±s), and compared between groups using independent sample t tests. Ranked data or enumeration data (e.g., total incidence of postoperative complications, Clavien-Dindo complication grading) were expressed as rates, and compared using the Rank Sum test or χ² test. Survival analysis curves were drawn by Kaplan-Meier, and survival differences between groups were compared by Log-Rank test.

There were no significant differences in intraoperative blood transfusion volume or hospitalization costs between the two groups (P>0.05). The cumulative overall survival rates showed no significant difference between the modified group and the control group (100.0% vs. 95.7%, Log-Rank χ²=1.887, P>0.05). Compared with the control group, the modified group had less intraoperative blood loss, shorter operation time, drainage tube indwelling time, anastomosis time, and hospital stay, as well as lower amylase levels in drainage fluid on the 1st postoperative day (all P<0.05). The total incidence of postoperative complications and Clavien-Dindo gradeⅠ-Ⅲcomplications in the modified group were lower than those in the control group (4.2% vs. 27.7%, P<0.05). The incidence of B/C-grade CR-POPF in the modified group was 2.1% (1/48), significantly lower than 17.0% (8/47) in the control group (P<0.05).

In LPD, modified pancreatic duct-jejunum bridge-type internal drainage optimizes anastomosis operations, shortens operation, anastomosis, and hospital stay durations, reduces intraoperative bleeding, and has a lower risk of postoperative complications. It is safer and more efficient than traditional pancreatic duct-jejunum mucosa anastomosis (including internal drainage).