胰腺创伤并发症的处理  

Management of pancreatic trauma.

作　　者：熊成龙[1] 章园[1] 向进见[1] 沈世强[1] 

机构地区：[1]武汉大学人民医院普通外科,武汉430060

出　　处：《华中医学杂志》2004年第5期282-283,共2页Central China Medical Journal

摘　　要：目的　探讨降低胰腺创伤并发症的处理方法。方法　总结近年来治疗胰腺外伤的病例和文献资料 ,对胰腺创伤的诊断、治疗、并发症和预后等进行综合分析。结果　多数胰腺损伤是在剖腹探查时才得以发现。根据胰腺损伤的病理类型选择缝合引流术、胰腺切除术、胰肠吻合术、胰十二指肠切除术等多种手术方式。胰瘘是胰腺外伤术后最常见的并发症 ,大多数可经适当的保守治疗自行闭合 ,极少数需手术治疗。结论　病情危重或延误诊断的胰腺损伤的处理宁简勿繁 ,若采取复杂的手术反而会增加术后并发症和手术死亡率 ;无论采取何种术式 ,损伤胰腺组织的彻底清创。Objective To study the management of pancreatic trauma in order to minimize the incidence of morbidity and mortality. Methods The current knowledge of pancreatic trauma, with emphasis on diagnosis, treatment, complications and outcome, is presented based on our limited experience and a literature review. Results The diagnosis of pancreatic trauma is usually made during laparotomy. At laparotomy, minor pancreatic injuries are best managed by drainage. Distal pancreatectomy is best suited for distal pancreatic trauma with ductal involvement. For severe trauma, pancreaticojejunostomy and Whipple's procedure are indicated according to the preoperative evaluation and intraoperative findings. Pancreatic fistulas are the most common complication and usually closed with medical treatment. Conclusion The severity of pancreatic injury and associated organ damage has prognostic and therapeutic implications. Independent of the procedure to be performed, drainage is mandatory for decreasing the morbidity and mortality.

关 键 词：术后并发症 胰腺创伤 治疗 胰腺损伤 胰腺外伤 诊断 处理 胰腺组织 缝合 

分 类 号：R657.5[医药卫生—外科学]