胰体尾切除术后胰瘘的相关性因素分析  

Risk factors for pancreatic fistula after distal pancreatectomy

作　　者：郭石[1] 卜献民[2] 戴显伟[2] 

机构地区：[1]沈阳市苏家屯区中心医院普外科,110101 [2]中国医科大学附属盛京医院肝胆胰肿瘤外科

出　　处：《中华普外科手术学杂志（电子版）》2011年第4期40-42,46,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

摘　　要：目的探讨胰体尾切除术后胰瘘发生的相关性因素。方法回顾性总结了82例行胰体尾切除的患者术前、术中操作以及术后并发症和死亡率发生的情况,并分析和术后胰瘘发生的相关性因素。结果术后有36名患者出现并发症占43.9%(36/82)。其中胰瘘是最常见的并发症,发生率为37.8%(31/82)。其中是否结扎主胰管和术后胰瘘的发生具有明显的相关性(P=0.010),而性别、年龄、是否并存糖尿病、胰腺的质地、术中失血量、是否预防性应用奥曲肽、是否用生物胶封闭胰腺断端、术后低蛋白血症和是否联合其它脏器切除均和胰瘘的发生无明显的相关性。结论胰体尾切除术后最常见的并发症仍然是胰瘘,术中单独结扎胰管可以减少胰瘘的发生率。Objective To investigate potential risk factors for pancreatic fistula（PF） after distal pancreatectomy.Methods We retrospectively reviewed 82 patients who had undergone distal pancreatectomy.The perioperative data and postoperative morbidity and mortality were collected.The risk factors for postoperative PF were analyzed.Results Of the 82 patients enrolled in the study,36 patients（43.9%） developed postoperative complications.PF was the most common complication with an incidence of 37.8%（31/82）.Ligation of the main pancreatic duct during the operation could significantly decrease the incidence of PF（P=0.010）.The other factors including age,gender,preoperative diabetes,normal or fibrotic pancreatic stump,intraoperative blood loss,prophylactic use of octreotide,reinforcement of pancreatic stump with fibrin glue,postoperative low albumin level and multivisceral resection were not closely related to the incidence of PF.Conclusions PF is still the most common complication after distal pancreatectomy.Elective ligation of the main pancreatic duct could lower the incidence of postoperative PF.

关 键 词：胰腺肿瘤 胰腺切除术 胰腺瘘 胰体尾切除 

分 类 号：R657.5[医药卫生—外科学]