闭合性胰腺损伤外科处理及胰瘘并发症分析  

The clinical analysis of surgical treatment and pancreatic fistulas for blunt pancreatic injuries

作　　者：毕杰[1] 顾炜[1] 陆飞[1] 刘文松[1] 吴鸣宇[1] 蔡兵[1] 

机构地区：[1]江苏省无锡市人民医院肝胆外科,214023

出　　处：《中国医疗前沿》2010年第17期43-44,80,共3页China Healthcare Innovation

摘　　要：目的探讨闭合性胰腺损伤外科处理方法和对胰瘘并发症进行分析。方法回顾性总结15年29例闭合性胰腺损伤病例的临床资料。结果据AAST分级确定胰腺损伤类型,选择缝合修补、胰腺切除、胰肠吻合及胰十二指肠切除等多种手术方式。Ⅲ、Ⅳ、Ⅴ级损伤并发症发生率较高,胰瘘是最常见的并发症。结论及时诊断和手术,选择合理的手术方式是外科治疗的关键;胰瘘与胰腺损伤程度、外科处理方法和操作技术密切相关。Objective To investigate the principle of surgical treatment of blunt pancreatic injuries and analyze the complications of pancreatic fistula. Methods Clinical data of 29 cases with pancreatic injuries in the past 15 years were studied retrospectively according to pancreatic injuries characteristics, surgical treatment and the complications of pancreatic fistula. Results The degree of pancreatic injuries was graded according to AAST. Minor pancreatic injuries are best managed by suture. Distal pancreatectomy is best suited for distal pancreatic injuries with ductal involvement. For severe injuries, pancreatectomy and Whipple＇s procedure are indicated according to the preoperative evaluation and intraoperative findings. Grade Ⅲ, Wand Ⅴ pancreatic injuries lead to increasing incidence of complications. Pancreatic fistulas are the most common complication. Conclusion Timely diagnosis and rational selecting operative procedures are vital to pancreatic injuries. Degree of pancreatic injuries, method of surgical treatment and operational technique are closely related to postoperative pancreatic fistula.

关 键 词：胰腺损伤 外科处理 胰瘘 

分 类 号：R657.5[医药卫生—外科学]