胆胰十二指肠结合部穿透性损伤的原因及治疗  

Reason and treatment of perforation injure on the junction of common bile duct,pancreas and duodenum

作　　者：甘险峰[1] 罗澜云[1] 安宁[1] 杨训[1] 周晓辉[1] 张刚[1] 

机构地区：[1]四川省人民医院肝胆外科,四川成都610072

出　　处：《四川医学》2007年第4期403-405,共3页Sichuan Medical Journal

摘　　要：目的探讨胆胰十二指肠结合部穿透性损伤(PBPD)的原因及治疗措施。方法回顾性分析18例胆胰十二指肠结合部穿透性损伤临床资料。结果13例于手术中发现,其中11例行胆管、十二指肠、空肠“三造瘘”+Oddis括约肌切开成形术,1例行Oddis括约肌切开成形术+胆肠吻合,1例行胆管引流、长臂T管支撑,13例均治愈。术后发现5例,2例经多次手术治愈,3例死于感染性休克。结论PBPD多发生于胆总管探查术中使用金属探条探查胆管下端,术中及术后早期发现疗效较好,合理的治疗方案是抢救PBPD成功的关键。Objective To investigate the reason and treatment of perforation injure on the junction of common bile duct, pancreas and duodenum（PBPD） .Method The clinical data of 18 patients with PBPD were retrospectively analyzed. Results Of the 18 cases, the injures of 13 cases were found during the operation, In this 13 cases, 11 were treated with 3-stoma（bile duct, pancreas, duodenum） ＋ oddi sphincteroplasty（OSP）, 1 with OSP ＋ choledochojejunostomy, 1 with T-tube drainage, all 13 cases were cured. The other 5 cases were not found during the primary operation, of this 5 cases, 2 cured after kinds of operations, 3 dead from infectious shock ~ Conclusions The most common cause of PBPD is using metal probe for exploration the end of the bile duct, Early diagnosis and reasonable therapy are the key point for successful treatment of PBPD.

关 键 词：胆总管 胰腺 十二指肠 损伤 诊断 治疗 

分 类 号：R656.1[医药卫生—急诊医学]