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作 者:周建平[1] 董明[1] 李新[1] 张磊[1] 孔凡民[1] 李昱骥[1] 田雨霖[1]
机构地区:[1]中国医科大学附属第一医院胃肠胰腺外科,辽宁沈阳110001
出 处:《中国现代医学杂志》2009年第2期309-311,共3页China Journal of Modern Medicine
摘 要:目的探讨胰十二指肠切除术(pancreatoduodenectomy,PD)术后早期并发症及死亡率发生、预防及处理的问题,提高PD手术的治疗效果。方法回顾性分析了该院2002年1月~2006年6月间97例采用标准PD手术和传统Child法消化道重建病人的术前状态、术中情况和术后并发症及死亡率。结果术后发生并发症49例(50.5%),其中胰瘘13例(13.4%),胆瘘3例(3.1%),肺内感染19例(19.6%),腹腔感染18例(18.6%),切口感染11例(11.3%),上消化道出血38例(39.2%),肠梗阻(肠套叠)1例(1%)。围手术期死亡6例(6.2%),其中1例为上消化道出血,2例为多脏器功能衰竭,1例为手术当日腹腔出血,1例为胰瘘继发腹腔感染,1例为肠系膜上动脉栓塞。结论PD手术具有较高的死亡率和并发症发生率。术前减黄治疗不能降低围手术期并发症的发生。[Objective] To analyze the morbidity and mortality and introduce the measures for prevention and treatment of complications after panereatoduodenectomy (PD). [Methods] The clinical data of 97 patients receiving PD in our hospital from 2002 to 2006 were analyzed retrospectively. [Results] All patients received standard PD and traditional Child method. Postoperative complication occurred in 49 patients (50.5%). Of these 49 cases, 13 (13.4%) suffered from pancreatic fistula, 3 (3.1%) from cholefistula, 19 (19.6%) from pulmonary infection, 18 (18.6%) from abdominal infection, 11 (11.3%) from incision infection, 38 (39.2%) from upper gastrointestinal hemorrhage, 1 (1%) from intestinal obstruction. Operative mortality was 6.2% (6 cases). [Conclusion] PD is still associated with high mortality and high morbidity rate. Minus jaundice before operation can not reduce the postoperative complications.
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