胰十二指肠切除术后并发症的防治进展  

Prevention and Treatment of Complications after Pancreatoduodenectomy

作　　者：李向阳 廖伟然 李婧[1] 李智豪[1] 朱红[1] LI Xiangyang;LIAO Weiran;LI ring;LI Zhihao;ZHU Hong(Department of Hepatobiliary and Pancreatic Surgery,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科二病区,昆明650101

出　　处：《医学综述》2018年第11期2221-2225,共5页Medical Recapitulate

摘　　要：胰十二指肠切除术(PD)是目前腹部外科最复杂、切除器官及组织最多的手术之一,由于手术创伤大,切除器官多,手术时间长,导致其术后高并发症发生率和围术期病死率。以往关于PD术后并发症的相关研究,由于缺乏统一的诊断标准及共识,且并发症的治疗经验不完善,导致其危险因素和防治均有不同之处。胰瘘和出血是术后早期主要并发症且是术后早期死亡的主要原因;术前应设立危险因素评分,针对高危险因素评分患者术前干预治疗,降低评分,以减少术后并发症的发生;C级胰瘘治疗效果差,应早期联合多学科综合治疗。Pancreatoduodenectomy（PD） is the most complicated operation among the abdominal surgeries,which requires to cut the most organs and tissues.Because of the large surgical trauma,excision of more organs,long operation time,the postoperative morbidity and mortality stay at a high level.Previous studies on postoperative complications of PD,due to lack of unified standard for diagnosis and consensus,lead to different findings in risk factors and prevention and treatment of postoperative complications.Pancreatic fistula and hemorrhage are major postoperative complications and the main causes of death;we should set up preoperative risk factors scoring system,and patients with high risk factors should be given preoperative interventions to reduce the incidence of postoperative complications;therapeutic effect for grade C pancreatic fistula is poor and early multidisciplinary comprehensive treatment should be administered.

关 键 词：胰十二指肠切除术 并发症 胰瘘 出血 

分 类 号：R657.5[医药卫生—外科学]