中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2013年
2期
109-112
,共4页
胰十二指肠切除术%吻合口瘘%胰瘘%治疗%预防
胰十二指腸切除術%吻閤口瘺%胰瘺%治療%預防
이십이지장절제술%문합구루%이루%치료%예방
Pancreaticoduodenectomy%Anastomotic fistula%Pancreatic fistula%Treatment%Prevention
胰十二指肠切除术后吻合口裂开合并腹腔大出血是严重威胁患者生命的致死性术后并发症.因此,胰十二指肠切除术后吻合口裂开和继发腹腔大出血的预防与治疗,一直是胰腺外科争论的焦点.手术处理术后并发症仍然是最为稳妥的治疗方法.但再次手术探查难度较大、方法多变且不易掌握,术后有再次发生吻合口瘘和出血的危险,有些术式可能损害胰腺全部内、外分泌功能.我们对多例胰十二指肠切除术后发生腹腔大出血患者施行主胰管空肠桥式导管引流术,患者术后效果良好,救治率达100％.该术式操作简便、安全性高、救治率高,还可保留剩余胰腺功能,是一种简易可行的应急手术方法.
胰十二指腸切除術後吻閤口裂開閤併腹腔大齣血是嚴重威脅患者生命的緻死性術後併髮癥.因此,胰十二指腸切除術後吻閤口裂開和繼髮腹腔大齣血的預防與治療,一直是胰腺外科爭論的焦點.手術處理術後併髮癥仍然是最為穩妥的治療方法.但再次手術探查難度較大、方法多變且不易掌握,術後有再次髮生吻閤口瘺和齣血的危險,有些術式可能損害胰腺全部內、外分泌功能.我們對多例胰十二指腸切除術後髮生腹腔大齣血患者施行主胰管空腸橋式導管引流術,患者術後效果良好,救治率達100％.該術式操作簡便、安全性高、救治率高,還可保留剩餘胰腺功能,是一種簡易可行的應急手術方法.
이십이지장절제술후문합구렬개합병복강대출혈시엄중위협환자생명적치사성술후병발증.인차,이십이지장절제술후문합구렬개화계발복강대출혈적예방여치료,일직시이선외과쟁론적초점.수술처리술후병발증잉연시최위은타적치료방법.단재차수술탐사난도교대、방법다변차불역장악,술후유재차발생문합구루화출혈적위험,유사술식가능손해이선전부내、외분비공능.아문대다례이십이지장절제술후발생복강대출혈환자시행주이관공장교식도관인류술,환자술후효과량호,구치솔체100％.해술식조작간편、안전성고、구치솔고,환가보류잉여이선공능,시일충간역가행적응급수술방법.
Pancreaticoduodenal anastomotic dehiscence complicated with peritoneal hemorrhage following pancreaticoduodenectomy is a serious complication which threatens patients'life.Prevention and mangement of pancreaticoduodenal anastomotic dehiscence and peritoneal hemorrhage is the focus in the surgical treatment.Operation is the most reliable treatment for bleeding.While reoperation is difficult for most surgeons and the risk of fistula and rebleeding after reoperation exist.Some procedures will affect the endocrine and exocrine function of pancreas.We applied pancreaticojejunal bridge drainage for most patients with hemorrhage after pancreaticoduodenectomy.This procedure is easy,safe,and can protect the pancreatic function.
