CAJ | 학술논문

目的探讨胰十二指肠切除术(pancreaticoduodenectomy,PD)后出血的原因和防治措施.方法回顾性分析2000年1月至2012年1月接受PD的422例患者的临床资料.结果 PD术后出血34例,发生率8.1％；死亡7例,死亡率20.6％.其中,早期出血19例,晚期出血15例；腹腔出血20例,消化道出血14例.再手术19例中死亡3例(15.8％).早期出血的死亡率低于晚期出血(P＜0.05).结论术中精细操作、确切止血,术后预防胰瘘、胆瘘及胰肠或胆肠吻合口周围积液是减少术后出血的关键.及时果断的再手术止血是治疗术后出血的重要手段.
목적 탐토이십이지장절제술(pancreaticoduodenectomy,PD)후출혈적원인화방치조시.방법 회고성분석2000년1월지2012년1월접수PD적422례환자적림상자료.결과 PD술후출혈34례,발생솔8.1％；사망7례,사망솔20.6％.기중,조기출혈19례,만기출혈15례；복강출혈20례,소화도출혈14례.재수술19례중사망3례(15.8％).조기출혈적사망솔저우만기출혈(P＜0.05).결론 술중정세조작、학절지혈,술후예방이루、담루급이장혹담장문합구주위적액시감소술후출혈적관건.급시과단적재수술지혈시치료술후출혈적중요수단.
Objective To study the cause,prevention and treatment of postpancreaticoduodenectomy hemorrhage.Method The clinical data of 422 patients who underwent PD in our hospital between January 2000 and January 2012 were retrospective analyzed.Results The incidence of postoperative hemorrhage was 8.1％ (34/422),and the mortality was 20.6％ (7/34).Early and delayed hemorrhage occurred in 19 and 15 patients,respectively.Intra-abdominal and gastrointestinal hemorrhage occurred in 20 and 14 patients,respectively.For the 19 patients who underwent reoperation,the mortality was 20.6％ (7/34).When compared with the delayed hemorrhage group,the mortality of the early hemorrhage group was significantly lower (P＜0.05).Conclusions Meticulous operation and reliable hemostasis during operation and prevention of pancreatic fistula,biliary fistula and peritoneal fluid collection after operation are the key points in reducing postoperative hemorrhage.A timely and decisive reoperation is important to manage postoperative hemorrhage.