胰十二指肠切除术后胃排空障碍的诊疗进展  

Research progress of delayed gastric emptying after pancreaticoduodenectomy

作　　者：刘祥 王城 武步强[1] LIU Xiang;WANG Cheng;WU Buqiang(Department of Hepatobiliary Surgery,Peace Hospital Affiliated to Changzhi Medical College,Changzhi,Shanxi 046000,P.R.China)

机构地区：[1]长治医学院附属和平医院肝胆外科,山西长治046000

出　　处：《中国普外基础与临床杂志》2020年第5期641-645,共5页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的总结胰十二指肠切除术(PD)后胃排空障碍诊疗的现状与进展。方法检索近年来国内外有关PD后胃排空障碍的相关研究文献并进行综述。结果目前胃排空障碍的病因及发病机制尚未完全阐明,与手术创伤、患者高龄、合并糖尿病、伴有其他腹部并发症等多种高危因素有关。保留幽门PD并不增加术后胃排空障碍的风险,而幽门环切除、结肠前吻合、Braun吻合、微创手术对降低其发生是有利的。胃排空障碍的治疗目前国内外仍无明显进展,但绝大多数患者可通过对症保守治疗获得痊愈。结论 PD后胃排空障碍应以预防为主,围术期应用术后加速康复策略可能是目前临床解决术后胃排空障碍的关键所在,但需进一步研究。Objective To discuss the current status and progress of delayed gastric emptying(DGE) after pancreaticoduodenectomy(PD). Method The related researches about DGE after PD in recent year were searched and reviewed. Results The etiology and pathogenesis of DGE had not yet been fully elucidated. There were various risk factors,such as the surgical trauma,advanced age,diabetes,and with other abdominal complications. The pylorus preserving PD didn’t increase the risk of DGE. The pylorus ring resection,anterior colon,Braun anastomosis,and minimally invasive surgery were beneficial for reducing DGE. Although there was no obvious progress in the treatment of DGE at home and abroad,the majority of patients could be cured by the symptomatic conservative treatment.Conclusions Prevention is a main strategy for DGE after PD. Application of enhanced recovery after surgery might be a key to solve problem in clinical,but further research is needed.

关 键 词：胰十二指肠切除术 胃排空障碍 治疗 

分 类 号：R657.5[医药卫生—外科学]