胰十二指肠切除术后早期并发症及其处理  

The early postoperative complications of pancreatoduodenectomy and their treatment

作　　者：许志伟[1] 王建承[1] 彭承宏[1] 吴卫泽[1] 雷若庆[1] 陈胜[1] 费健[1] 朱坚[1] 邓漾[1] 张卓[1] 陆晔[1] 张圣道[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院外科,上海200025

出　　处：《外科理论与实践》2009年第1期36-39,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:总结胰十二指肠切除术(pancreatoduodenectomy,PD)后早期并发症及其处理经验。方法:回顾2004～2006年瑞金医院外科81例PD的临床资料,分析其早期并发症的相关危险因素和处理方法。结果:本组术后早期并发症发生率为25.9%(21/81),多见的并发症包括出血、胰漏、胆漏、腹腔感染等。统计分析显示与早期并发症有关的因素包括年龄>65岁、术前血清总胆红素>100μmol/L、术中输血量>1000mL及未放置胰管内支架引流。结论:年龄、黄疸、手术创伤是影响PD术后早期并发症的高危因素,放置胰管内支架有利于减少并发症发生。Objectives To study tile early postoperative complications of panereatoduodenectomy （PD） and their treatment. Methods The clinical data from 81 patients undergoing PD in Ruijin Hospital from 2004 to 2006 was collected and analyzed to investigate the high risk factors of postoperative complications and their treatment strategies. Results The early postoperative complication rate was 25.9 % （21/81）. The commomly seen complications included bleeding, panereatic or biliary anastomotic leakage and abdominal infection. The statistical analysis revealed that age over 65 years, preoperative total serum bilirubin level over 100 μmol/L, intraoperative blood transfusion over 1 000 mL and failure to use pancreatic duct stent drainage were important risk factors of early complications. Conclusions Age, jaundice and operative injury are the high risk factors of the early postoperatire complications of PD. The use of pancreatic duct stent drainage may be helpful to decrease the complication rate.

关 键 词：胰头十二指肠切除术 手术后并发症 危险因素 综合疗法 再手术 

分 类 号：R735[医药卫生—肿瘤]