远端胰腺切除术后胰瘘的诊疗进展  

Progress in the diagnosis and treatment of pancreatic fistulaafter distal pancreatectomy

作　　者：李春梅[1] 唐继红[1] 何敏[1] 白宇凡 李志斌 LI Chunmei;TANG Jihong;HE Min;BAI Yufan;LI Zhibin(Department of Hepatobiliary and Pancreatic Surgery,The Second Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650101,China)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科,云南昆明650101

出　　处：《中国临床研究》2024年第4期601-606,共6页Chinese Journal of Clinical Research

摘　　要：远端胰腺切除术(DP)是治疗胰腺体、尾部良、恶性肿瘤以及慢性胰腺炎等疾病的标准术式,被广泛应用于临床,约占所有胰腺切除术的25%。术后胰瘘(POPF)在胰腺术后并发症中发生率最高,严重的POPF还可继发出血、感染等局部或全身并发症,是一种潜在的严重的可危及生命的事件。与胰十二指肠切除术相比,DP不需要进行胰肠、胆肠、胃肠的吻合,术式简单,术后并发症发生率低,病死率不足1%,但POPF的发生率却远高于胰十二指肠切除术,DP术后一旦发生胰瘘,患者病死率将会升高到20%~40%。近年来,随着手术方法和理念的发展,DP术后并发症的情况有了明显改善,但POPF的发生率仍较高,疾病迁延不愈给患者带来经济和心理负担,同时降低其生活质量。本文主要从诊断、危险因素、预防及治疗三方面对POPF的最新研究进展进行综述,旨在提高临床医生对POPF的认识。Distal pancreatectomy(DP)is a standard procedure for treating benign and malignant tumors of the pancreatic body and tail and chronic pancreatitis.It is widely performed in clinics,accounting for approximately 25%of all pancreatectomies.The incidence of postoperative pancreatic fistula(POPF)is the highest among postoperative complications of pancreatic surgery,and severe POPF can also lead to local or systemic complications such as bleeding and infection,which is a potentially serious and life-threatening disease.Compared with pancreaticoduodenectomy,DP does not require anastomosis of pancreatic-intestine,biliary-intestine and stomach-intestine,and is a simple surgical procedure with a low incidence of postoperative complications and less than 1%mortality.However,the incidence of POPF after DP is much higher than that of pancreaticoduodenectomy,and once POPF occurs,the mortality of patients will increase,reaching 20%to 40%.In recent years,with the development of surgical methods and concepts,the situation of complications after DP has been significantly improved,but the incidence of POPF is still high,and the prolonged disease brings economic and psychological burden to patients and reduces their quality of life.This article mainly reviews the latest research progress on POPF from three aspects:diagnosis,risk factors,prevention and treatment,aiming to improve physicians understanding of POPF.

关 键 词：远端胰腺切除术 胰十二指肠切除术 术后胰瘘 危险因素 胰周引流 内镜治疗 外科治疗 

分 类 号：R656[医药卫生—外科学]