肝胆胰手术后切口疝修补术的难点与进展  

Difficulties and advances of incisional hernia repair after hepatobiliary and pancreatic surgery

作　　者：黄永刚 叶静 金华 刘治坤 徐骁[2] Huang Yonggang;Ye Jing;Jin Hua;Liu Zhikun;Xu Xiao(Department of Hernia and Abdominal Wall Surgery,Affiliated Hangzhou First People′s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China;Department of Hepatobiliary Surgery,Affiliated Hangzhou First People′s Hospital,Zhejiang University School of Medicine,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属杭州市第一人民医院疝和腹壁外科,杭州310006 [2]浙江大学医学院附属杭州市第一人民医院肝胆胰外科,杭州310006

出　　处：《中华消化外科杂志》2022年第9期1234-1239,共6页Chinese Journal of Digestive Surgery

基　　金：浙江省医药卫生科技计划项目(2021431768)。

摘　　要：腹壁切口疝是腹部手术后腹壁肌筋膜层愈合不良产生的腹壁缺损和腹腔脏器经缺损突出的疾病,其发生率为5.0%~20.0%。肝胆胰手术后切口疝的发生率更高。尽管腹壁切口关闭方法、疝修补技术和材料均取得很大进步,但腹壁切口疝的总体发生率、修补效果和预后改善仍不明显。肝胆胰手术后切口疝较复杂,其修补术难点问题包括有效控制和治疗基础疾病、选择更佳的手术方式、合理采用多种腹壁缺损关闭和重建技术、降低术后并发症风险等。全世界腹壁切口疝修补术和关腹的相关指南相继发布和更新。笔者总结肝胆胰手术后切口疝修补术的难点与进展,旨在提高肝胆胰手术后切口疝治疗水平,改善患者预后。Abdominal incisional hernia is caused by poor healing of myofascial layer of abdominal wall and abdominal visceral organs protruding through the defect after abdominal surgery.The incidence of abdominal incisional hernia is 5.0%‒20.0%,even higher after hepatobiliary and pancreatic surgery.Although great progress has been made in the methods of abdominal incision closure,hernia repair technology and materials,the overall incidence,repair effect and prognosis of abdominal incisional hernia are still not significantly improved.The incisional hernias after hepatobiliary and pancreatic surgery are relatively more complex,and the difficult problems of surgical repair are more prominent,including effectively controlling basic diseases,choosing a better surgical method,reasonably using a variety of abdominal wall defect closure and reconstruction techniques,and reducing the risk of postoperative complications.Relevant guidelines for abdominal incisional hernia repair and abdominal closure have been issued and updated all over the world.In order to improve the treatment of incisional hernia after hepatobiliary and pancreatic surgery and improve the prognosis of patients,the authors summarize the difficulties and new progress in the repair of incisional hernia after hepatobiliary and pancreatic surgery.

关 键 词：疝 切口疝 疝修补术 腹壁重建 肝胆胰手术 

分 类 号：R656.2[医药卫生—外科学]