CAJ | 학술논문

目的回顾胰十二指肠切除术后并发症治疗的经验体会,分析并发症发生的原因,探讨减少并发症发生的治疗措施.方法回顾性分析北京军区总医院肝胆外科2001年3月-2011年4月行胰十二指肠切除术的患者62例,其中男41例,女21例.年龄为42～76岁,平均(59.3±4.1)岁.分为早期组24例和近期组38例,分别从围手术期处理、胰肠吻合方式与材料的选择、胃肠吻合的方式的选择、术野创面血管的处理、防止吻合口漏及创面出血材料的使用等方面总结不同时期使用不同处理方法的效果,并比较两组术后胰漏、出血、腹腔感染、胃潴留、术后胆道感染、肝脓肿及切口感染7项术后并症的发生情况.结果早期组:胰漏10例,出血4例,腹腔感染10例,胃潴留9例,术后胆道感染11例,术后肝脓肿6例,切口感染7例.近期组分别为4、0、0、1、2、0和3例.两组比较近期组术后的并发症有明显下降,近期组较早期组7项指标差异均有统计学意义.结论胰十二指肠切除术创伤大,并发症严重,重视微创理念和优质材料的应用,加强围手术期的管理是降低术后并发症的有效措施.
목적 회고이십이지장절제술후병발증치료적경험체회,분석병발증발생적원인,탐토감소병발증발생적치료조시.방법 회고성분석북경군구총의원간담외과2001년3월-2011년4월행이십이지장절제술적환자62례,기중남41례,녀21례.년령위42～76세,평균(59.3±4.1)세.분위조기조24례화근기조38례,분별종위수술기처리、이장문합방식여재료적선택、위장문합적방식적선택、술야창면혈관적처리、방지문합구루급창면출혈재료적사용등방면총결불동시기사용불동처리방법적효과,병비교량조술후이루、출혈、복강감염、위저류、술후담도감염、간농종급절구감염7항술후병증적발생정황.결과 조기조:이루10례,출혈4례,복강감염10례,위저류9례,술후담도감염11례,술후간농종6례,절구감염7례.근기조분별위4、0、0、1、2、0화3례.량조비교근기조술후적병발증유명현하강,근기조교조기조7항지표차이균유통계학의의.결론 이십이지장절제술창상대,병발증엄중,중시미창이념화우질재료적응용,가강위수술기적관리시강저술후병발증적유효조시.
Objective To discuss the treatment of complications post-pancreticoduedenectomy by reviewing the experiences from 62 cases.Methods Sixty-two cases of pancreticoduedenectomy from March 2001 to April 2011,mean age 59.3 ±4.1 years,were reviewed.All cases were divided into early group 24 cases and recent group (38 cases) by the difference in following aspects:perioperative management,the way of pancreatic bowel anastomosis and material choice,the vessels management,materials using in preventing leakage and bleeding.The differences in leakage,bleeding,infection,the stomach retention,biliary infections,liver abscess and incision infection in two groups were compared.Results The early group showed pancreatic leakage in 10 cases,bleeding in 4 cases,celiac infection in 10 cases,gastric retention in 9 cases,biliary infections in 11 cases,liver abscess in 6 and infection of incision in 7 cases,respectively.Recent groups were in 4,0,0,0,1,2 and 3 cases,respectively.The comparisons showed the complications had reduced significantly in recent group than in the early group (x2 =77.08,P ＜ 0.001 ).Conclusions Minimally invasive and high quality materials use,strengthening the perioperative management are the effective measures to reduce the postoperative complications.