胰十二指肠切除术后出血的选择性血管造影及动脉栓塞治疗  

Treatment of hemorrhage after pancreatoduodenectomy by selective angiography and arterial embolism

作　　者：李志强[1] 牟玮[2] 张丰深[1] 

机构地区：[1]解放军324医院肝胆外科,重庆400020 [2]第三军医大学第一附属医院放射科

出　　处：《西南国防医药》2012年第1期50-52,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的探讨胰十二指肠切除术后出血的选择性动脉栓塞治疗的处理原则及方法。方法总结我院2006～2009年期间胰十二指肠切除术后出血5例的诊治经验,就其发生的时间、临床表现、出血原因、出血部位、处理方法与结果进行分析。结果体腔引流管道内或周围出血是所有病例的共同临床表现,4例合并术后胰瘘。所有病例均行血管造影检查,4例发现明确出血血管并行选择性动脉栓塞,未再出血;1例未发现明确出血部位,后并发MODS死亡。结论急诊选择性动脉造影检查及栓塞是明确胰十二指肠切除术后出血原因、部位及止血的良好诊疗方法。Objective To discuss the principles and methods of handling the hemorrhage after pancreatoduodenectomy by selective arterial embolism. Methods The diagnostic and therapeutic experiences of 5 patients with hemorrhage after pancreatoduodenectomy in our hospital from 2006 to 2009 were summarized. And analysis was made in occurrence time, clinical manifestation,causes of bleeding,bleeding parts, methods of treatment and results. Results Bleeding in/out of coelom drainage tube was the common manifestation for all the patients. Complication of postoperative pancreatic fistula occurred in 4 cases. All cases received the examination of angiography. In 4 cases, exact bleeding vessel was found. The selective arterial embolism was carried out and rebleeding was not occurred. The bleeding part was not found in a case that eventually died of the complication of multiple organ dysfunction syndrome（MODS）. Conclusion Emergency selective arterial angiography and embolism is a good method to identify bleeding causes and parts, and to stop bleeding.

关 键 词：胰十二指肠切除术 术后出血 选择性血管造影 动脉栓塞 治疗 

分 类 号：R738.1[医药卫生—肿瘤]