闭合性胰腺外伤的诊治体会(附19例报告)  

EXPERIENCE IN DIAGNOSIS AND TREATMENT OF CLOSED PANCREATIC INJURY:A REPORT OF 19 CASES

作　　者：张国伟[1] 周杰[1] 廖彩仙[1] 赵国湘[1] 

机构地区：[1]第一军医大学南方医院肝胆外科,广州510515

出　　处：《肝胆外科杂志》2003年第6期414-416,共3页Journal of Hepatobiliary Surgery

摘　　要：目的　探讨闭合性胰腺外伤的早期诊治经验。方法　回顾性分析总结我院 1 994～ 2 0 0 2年收治 1 9例闭合性胰腺外伤的病例资料。　结果　 1 9例患者中 1 6例合并其它器官损伤 ,9例在剖腹探查术中才发现胰腺损伤。胰十二指肠切除 2例、全胰切除 1例、十二指肠憩室化 2例、胰体尾脾切除 5例、胰腺清创与外引流 7例、拒绝手术 1例。并发胰外瘘和胰腺假性囊肿4例。治愈 1 6例 ,死亡 3例。结论　剖腹探查术是早期诊断最简单可靠的方法。闭合性腹外伤中保持对胰腺外伤的警惕 ,并在剖腹探查术中常规探查胰腺是早期发现和避免漏诊胰腺外伤的关键。术式的选择应综合考虑胰腺损伤的类型 。Objective To accumulate the experience in diagnosis and management of closed pancreatic injury.Methods From 1994 to 2002,19 patients with closed pancreatic injury treated in our hospital were reviewed retrospectively.Results 16 of them had multiple organs trauma.Pancreatic injury in 9 patients were discovered during laparotomy.Pancreato duodenectomy,duodeno diverticularization,resection of spleen and body tail of pancreas,pancreatic debridement and external drainage was perfumed in 2,2,5 and 7 cases respectively.1 case refused the operation .4 patients complicated with pseudocyst and abdominal fistula of pancreas.16 cases recovered.3 cases died.Conclusion Exploratory laparotomy was the key in early diagnosis.It was important the alert pancreatic injury in diagnosi and explore pancreas by laparotomy to discover pancreatic injury early and avoid missing diagnosis.The grade of pancreatic injury,the integrality of pancreatic duct,and the condition of combined injury should be considered during the selection of operation.

关 键 词：胰腺损伤 诊断 治疗 

分 类 号：R657.5[医药卫生—外科学]