胰十二指肠切除术后胰瘘发生危险因素认识及评价  

Risk factors of pancreatic fistula after pancreaticoduodenectomy

作　　者：杨尹默[1] 

机构地区：[1]北京大学第一医院外科,北京100034

出　　处：《中国实用外科杂志》2015年第8期808-811,共4页Chinese Journal of Practical Surgery

摘　　要：胰十二指肠切除术是治疗壶腹部肿瘤的经典术式,术后并发症发生率较高,其中以胰瘘最常见,可致感染、出血甚至死亡。近年来,围绕术后胰瘘问题不断有各种改良术式出现,研究方法也逐步从回顾性研究过渡至前瞻性研究。影响胰瘘发生及严重程度的危险因素包括病人自身情况、重建方式及术者操作水平等。目前尚无具有显著优越性的吻合方式,术者可根据经验及熟悉程度选择,应强调及注重术者技术性因素对胰瘘发生的影响,提高胰腺消化道重建的质量。Pancreaticoduodenectomy offers the only chance of curative resection for periampullary tumors, which is technically challenging and is accompanied by a substantial risk for postoperative eomplieations. The most significant complication is pancreatic fistula which often causes infectious complications, hemorrhage, which makes it the leading risk factor for postoperative death. Risk factors for development of pancreatie fistula are now well known, and several technical modifications, which focus on the type of pancreatic anastomosis, duct stenting, somatostatin and analogues, have been suggested in prevention of pancreatic fistula. Although no one technique of pancreatic anastomosis has been shown to be superior in decreasing the rate of pancreatic fistula, meticulous attention to intraoperative details by surgeons is necessary to prevent pancreatic fistula.

关 键 词：胰十二指肠切除术 胰腺切除术 消化道重建 胰瘘 

分 类 号：R6[医药卫生—外科学]