应用胰管盆式内引流术治疗慢性胰腺炎18例疗效分析  

Analysis of the efficacy of basin-type pancreatico-enterostomy in chronic pancreatitis: A report of 18 patients

作　　者：姚佳水 陈梅福[1] 成伟[1] 朱朝庚[1] 李国光[1] 蔡翊 曹中文 YAO Jia-shui;CHEN Mei-fu;CHENG Wei(Department of Pancreatic and Splenic Surgery,the First Affiliated Hospital of Hunan Normal University(Hunan Provincial People’s Hospital),Translational Medicine Laboratory of Pancreas Disease of Hunan Normal University,Changsha 410005,China)

机构地区：[1]湖南师范大学附属第一医院(湖南省人民医院)胰脾外科,湖南师范大学胰腺疾病转化医学研究所,湖南长沙410005

出　　处：《中国实用外科杂志》2020年第7期817-819,823,共4页Chinese Journal of Practical Surgery

基　　金：湖南省科学技术科技计划项目(No.2011FJ3210)。

摘　　要：目的探讨胰管盆式内引流术在慢性胰腺炎治疗中的应用及疗效。方法回顾性分析2016年12月至2019年6月湖南省人民医院行胰管盆式内引流术治疗的18例慢性胰腺炎病人的临床资料。合并胰管结石16例,合并胰周假性囊肿18例,合并胰周脓肿5例。均行胰管盆式内引流术。结果18例病人均顺利完成胰管盆式内引流术,手术时间为(3.5±1.2)h,术中出血量为(153.8±30.7)mL。术后6例(33.3%)病人带管出院,其余病人术后拔管时间(8.0±1.5)d;有1例(5.6%)病人术后连续3 d桥袢引流管引流少量暗红色液体,予以保守治疗后愈合,其余病人均未出现并发症,无死亡病例。18例病人均获得随访,随访时间为1~28个月,效果满意,有1例(5.6%)术后27个月时再发胰腺炎,经保守治疗好转,其余病人未再发胰腺炎。结论采用胰管盆式内引流术一期处理慢性胰腺炎急性发作亚急性期病人,可缩短治疗时间,且有效缓解病人腹痛症状,防止胰腺炎复发,保护胰腺内外分泌功能,改善病人生存质量。Objective To investigate the application and curative effect of basin-type pancreatico-enterostomy in the treatment of chronic pancreatitis.Methods The clinical data of 18 patients with chronic pancreatitis treated with basintype pancreatico-enterostomy in People’s Hospital of Hunan Province from December 2016 to June 2019 were analyzed retrospectively.Among them,16 cases were complicated with pancreatic duct stones.Combined with peri-pancreatic pseudocysts was in 18 cases,combined with peri-pancreatic abscess in 5 cases.Basin-type pancreatico-enterostomy were performed in all patients.Results All 18 patients successfully completed the operation.The operation time was(3.5±1.2)h.The intraoperative blood loss was(153.8±30.7)mL.Six patients left hospital with bridge drainage tube after surgery.The postoperative extubation time of the others was(8.0±1.5)d.There was a patient who had a spot of bloody liquid in the bridge intestinal tube for 3 consecutive days after surgery and recovered with conservative treatment.No complications and deaths occurred.A total of 18 patients were followed up for 1 to 28 months,and the results were satisfactory.In one case,pancreatitis occurred in 27 months after surgery and recovered with conservative treatment.The rest of the patients did not develop pancreatitis again.Conclusion Basin-type pancreatico-enterostomy can safely handle the subacute phase of acute episode of chronic pancreatitis,and shorten the treatment time.It can effectively relieve the symptoms of abdominal pain in patients,prevent the recurrence of pancreatitis,protect the endocrine and exocrine function of the pancreas and improve the quality of life.

关 键 词：慢性胰腺炎 亚急性期 胰管结石 胰管盆式内引流术 

分 类 号：R6[医药卫生—外科学]