膀胱引流式同期胰肾联合移植术后胰漏的处理  

Management of pancreatic leak in bladder-drained simultaneous pancreas and kidney transplantation recipients

作　　者：黄倩[1] 邢昕彤 匡柏成 卢峡[1] 宫念樵[1] 张伟杰[1] 明长生[1] HUANG Qian;XING Xintong;KUANG Baicheng(Institute of Organ Transplantation,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院器官移植研究所,器官移植教育部重点实验室,国家卫生健康委员会器官移植重点实验室,中国医学科学院器官移植重点实验室,武汉430030

出　　处：《临床外科杂志》2022年第3期266-268,共3页Journal of Clinical Surgery

基　　金：中国器官移植发展基金“移植领创计划2021”。

摘　　要：目的 总结膀胱引流式同期胰肾联合移植(simultaneous pancreas and kidney transplantation, SPK)术后胰漏的治疗经验。方法 SPK术后胰漏病人3例,结合文献对SPK术后胰漏的临床诊疗进行探讨。结果 3例SPK受者的移植胰腺外分泌均为膀胱引流,其中2例早期胰漏,1例远期胰漏。对3例病人予以抗生素治疗、抑制胰腺外分泌、膀胱减压、维持水电解质酸碱平衡、营养支持等治疗,根据具体情况行通畅引流或瘘口修补。所有病人胰漏均痊愈,无移植物丢失或病人死亡。结论 膀胱引流式SPK术后胰漏,可行抑制胰液外分泌、膀胱减压、通畅引流等治疗;胰漏长期不愈者,瘘口修补可作为一种有效治疗方法。Objective To investigate the treatment strategies of pancreatic leak in bladder-drained simultaneous pancreas and kidney transplantation(SPK) recipients.Methods Retrospective, three cases of SPK recipients with pancreatic leakage, all medical history, clinical data, and treatment strategies were recorded and analyzed.Results All the three SPK recipients had bladder-drained pancreatic grafts.Pancreatic leakage occurred in two patients during the perioperative period of SPK and in one recipient at one-year post-transplantation.Bladder decompression, full drainage and transplanted duodenum fistula repair were the main strategies, in addition to symptomatic supportive treatments including antibiotic treatment, inhibition of pancreatic exocrine secretion, maintenance of homeostasis and nutritional support.Eventually, all the 3 patients were successfully cured without any graft loss or patient death.Conclusion Severe pancreatic leakage in SPK patients can lead to serious consequences, which can be effectively treated by drainage and transplanted duodenum fistula repair.

关 键 词：胰肾联合移植 膀胱引流式 胰漏 

分 类 号：R699.2[医药卫生—泌尿科学] R657.5[医药卫生—外科学]