胰十二指肠切除术后胰肠吻合口瘘的外科手术处理  

The surgical treatment of pancreatic anastomotic leakage after pancreaticoduodenectomy

作　　者：刘剑鸣[1] 易为民[1] 彭创[1] 吴金术[1] LIU Jian-ming;YI Wei-min;PENG Chuang;WU Jin-shu(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Hunan Normal University/Hunan Provincial People's Hospital,Changsha 410005,China)

机构地区：[1]湖南师范大学第一附属医院/湖南省人民医院肝胆外科

出　　处：《肝胆胰外科杂志》2019年第12期719-722,共4页Journal of Hepatopancreatobiliary Surgery

摘　　要：目的探讨胰十二指肠切除术后胰肠吻合口瘘的外科治疗。方法回顾性分析湖南省人民医院2017年10月至2018年7月收治的8例胰十二指肠切除术后并发胰肠吻合口瘘(均为C级胰瘘)的患者临床资料,探讨其外科治疗效果。结果8例均救治成功,术后均未再出现B级或C级胰瘘,腹部症状和体征逐渐消失,平均住院时间31.9 d。结论胰十二指肠切除术后并发严重胰肠吻合口瘘应当早期发现,及时进行手术处理;术中腹膜腔彻底的清洗、恰当的缝合、充分的减压与引流,可以达到良好的治疗效果,值得借鉴和推广。Objective To analyze the surgical treatment of pancreatic anastomotic leakage after pancreaticoduodenectomy.Methods The clinical data of 8 patients with pancreatic anastomotic leakage(all of them were grade C pancreatic leakage)following pancreaticoduodenactomy at Hunan Provincial People’s Hospital from Oct.2017 to Jul.2018 were retrospectively analyzed,and the surgery outcomes were discussed.Results All of the 8 cases were successfully treated,and no grade B or C pancreatic leakage occurred after operation.Abdominal symptoms and signs gradually disappeared after surgery,the average time of hospitalization stay after surgery was 31.9 days,and all the 8 patients were eventually cured and discharged.Conclusion Early detection and immediate surgical treatment is required for severe pancreatic anastomotic leakage after pancreaticoduodenectomy.In order to obtain good treatment results,peritoneal cavity should be cleaned thoroughly,sutured properly,decompressed and drained sufficiently.

关 键 词：胰十二指肠切除术 胰肠吻合口瘘 

分 类 号：R657.5[医药卫生—外科学]