完全性胰液外引流预防胰十二指肠切除术后胰瘘的机理分析  

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

作　　者：吴国忠[1] 姜杰[1] 庞绍春[1] 

机构地区：[1]广东省农垦中心医院普外科,湛江524002

出　　处：《中国现代手术学杂志》2011年第4期262-263,共2页Chinese Journal of Modern Operative Surgery

基　　金：湛江市科技攻关项目(2010C3106018)

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机理。方法 35例胰十二指肠切除术,在Child术式基础上附加完全性胰液外引流,再分别对胃管、腹腔引流管、胰液引流管内的引流液进行淀粉酶定量测定分析。结果各引流管引流液淀粉酶平均测定结果为:胃管引流液412.3(254～626)U/L,腹腔引流液23.5(15～46)U/L,胰液引流管为128 196.1(16 474～295 640)U/L。全组无胰瘘发生,无围手术期死亡病例。结论完全性胰液外引流可以使胰肠吻合口处于相对"无胰酶"状态,对预防胰十二指肠切除术后胰瘘的发生起着关键作用。Objective To investigate the mechanisms of complete external drainage of pancreatic fluid on preventing pancreatic fistula after pancreaticoduodenectomy. Methods From January 2004 to September 2010, thirty-five cases underwent pancreaticoduodenectomy and an additional complete external drainage of pancreatic fluid based on Child surgery. Then the liquid, which was drained from the gastric tube, the peritoneal drainage tube and pancreatic fluid drainage tube, was put for analysis of quantitative determination of pancreatic amylase. Results The mean determination results of amylase drainage fluid were 412.3 （254 ± 626） U/L of the gastric tube, 23.5 （15 ±46）U/L of the peritoneal drainage tube and 128 196.1 （16 474 ±295 640）U/L of the pancreatic drainage tube. There was no incidence of pancreatic fistula or perioperative deaths. Conclusion Complete external drainage of pancreatic fluid can make the pancreaticojejunostomosis in a relatively ＂no trypsin state＂, which plays a key role in the prevention of the pancreatic fistula after pancreatoduodenectomy.

关 键 词：引流术 胰十二指肠切除术 胰瘘 

分 类 号：R656.6[医药卫生—外科学] R657.5[医药卫生—临床医学]