完全性胰液外引流预防胰十二指肠切除术后胰瘘  

Prevention of Pancreatic Fistula after Pancreaticoduodenectomy Using Complete External Drainage of Pancreatic Fluid

作　　者：吴国忠[1] 刘华安[1] 姜杰[1] 曹锡朝[1] 

机构地区：[1]广东省湛江市农垦中心医院外科,湛江 524002

出　　处：《中国现代手术学杂志》2005年第3期225-227,共3页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨完全性胰液外引流预防胰十二指肠切除术后胰瘘的疗效.方法回顾性分析1992年1月～2004年5月62例行胰十二指肠切除后在Child术式基础上附加胰液完全外引流的病例资料.结果本组术后无胰瘘发生,3周左右拔除胰管引流管.发生并发症13例,包括肺部感染4例、右胸腔积液2例、切口裂开2例,胰腺残端大出血、胃排空延迟、腹腔脓肿各1例,局限性腹膜炎2例,予相应处理后治愈.死亡1例,死于隐匿性糖尿病、高渗性昏迷.结论完全性胰液外引流可避免胰肠吻合口处胰液的积聚,避免胰酶对吻合口的腐蚀,对预防术后胰瘘的发生起重要作用.Objective To investigate the effect of complete external drainage of pancreatic fluid on preventing pancreatic fistula after pancreaticoduodenectomy. Methods 62 cases underwent pancreaticoduodenectomy and Child alimentary tract reconstruction and complete external drainage of pancreatic fluid from January 1992 to May 2004 were retrospectively reviewed. Results Pancreatic draining tube were removed 3 weeks postoperatively with no pancreatic fistula occurred. There were 13 cases of complications including pulmonary infection in 4 cases, right pleural effusion in 2 cases, disruption of incision in 2 cases, massive hemorrhage from pancreatic stump, delayed gastric empty and peritoneal abscess in 1 case for each, local peritonitis in 2 cases. There was 1 death due to hyperosmolar nonketotic diabetic coma. Conclusion Complete external drainage of pancreatic fluid can avoid the collection of pancreatic juice and the subsequent erosion to pancreaticojejunostomosis, playing a key role in preventing the pancreatic fistula.

关 键 词：胰腺瘘 引流术 胰十二指肠切除术 完全性 胰液外引流 胰管 

分 类 号：R656[医药卫生—外科学]