胰十二指肠切除64例术后胰瘘的预防  

Prevention for pancreatic fistula after pancreaticoduodenectomy

作　　者：毛盛名[1] 梁海飞[1] 林建清[1] 肖强[1] 任旋磊[1] 张斌[1] 李谦[1] 

机构地区：[1]清远市人民医院肝胆外科,511500

出　　处：《中华普通外科学文献（电子版）》2011年第4期23-24,共2页Chinese Archives of General Surgery(Electronic Edition)

摘　　要：目的探讨如何有效预防胰十二指肠切除(PD)术后胰瘘的发生。方法回顾性分析64例PD患者的临床资料并加以比较分析,对导致PD术后胰瘘的最常见原因以及预防措施进行探讨。结果 64例PD有7例发生术后胰瘘,其中5例经非手术治疗痊愈,1例死于严重的腹腔感染和随后的多器官功能衰竭。发生胰瘘的患者平均住院时间为35.8(18～93)天。结论充分的术前准备,根据胰腺本身及周围情况选择适当的术式,胰肠吻合口的充分减压,术后通畅的腹腔引流以及术中生物蛋白胶和术后奥曲肽的应用对预防PD术后胰瘘有益。Objective To explore effective measurements to prevent pancreatic fistula after pancreati- coduodenectomy （PD）. Methods The clinical information of 64 patients of PD were restrospectively analyzed. the causative factors and preventive ts for pancreatic fistula after PD were investigated. Results Of 64 patients, there were 7 cases of pancreatic fistula, 5 of whom were healed by nonsurgical treatments and 1 died of severe intraabdominal infection and MOF. The average hospital stay of pancreatic fistula patients was 35.8 days with a range of 18 to 93 days. Conclusion Sufficient preoperative preparation, proper operation modality according to texture of the pancreas and the condition of peripancreas, adequate decompression of the pancreaticoenteric anastomosis, patency of abdominal drainge in combination with intraoperative use of bioprotein gel and postoperative administration of octreotide are helpful for precaution of pancreatic fistula after PD.

关 键 词：胰十二指肠切除 胰瘘 预防 

分 类 号：R656[医药卫生—外科学]