胰腺不同疾病术后胰瘘的危险因素分析

目的:探讨胰腺癌、胰腺神经内分泌肿瘤、慢性胰腺炎手术治疗对术后胰瘘发生的影响。方法:回顾性分析我院2000年5月至2011年5月间行胰腺手术患者的临床病理资料,共197例患者因胰腺癌、胰腺神经内分泌肿瘤、慢性胰腺炎行胰腺手术。收集患者手术方式和有无胰瘘发生,其中胰瘘分A、B、C三级。结果:43例患者为神经内分泌肿瘤,127例患者为胰腺癌,27例患者为慢性胰腺炎。神经内分泌肿瘤患者术后胰瘘发生率明显高于胰腺癌、慢性胰腺炎(P<0.01)。胰腺肿瘤摘除术后胰瘘发生率高于其它手术方式(P=0.001)。结论:在排除了不同级别的胰瘘、术后不同的处理方法后,神经内分泌肿瘤术后发生胰瘘的风险比其他胰腺疾病术后发生胰瘘的风险大,应更加重视胰腺内分泌肿瘤的手术治疗。

Analysis of risk factors for postoperative pancreatic fistula of different pancreatic diseases

Objective:Explore and discuss the effects of pancreatic fistula(PF) after a surgery on patients with pancreatic cancer(PC),neuroendocrine pancreatic tumors(NPT) and chronic pancreatitis(CP).Methods: The clinical pathologic data of 197 patients who underwent a pancreatic surgery from May 2000 to May 2011 in our hospital were retrospectively evaluated.All of the patients were with PC,NPT or CP.The methods of the surgery have been collected.And the happening of PF is considered.Three different grades of PF(grades A,B,C) were defined.Results: There are 43 patients with NPT,127 patients with PC and 27 patients with CP.Patients with NPT have an obvious higher danger of developing a PF than patients with PC and CP(P<0.0001).The incidence rate of PF after the extraction of pancreatic tumor is higher than other surgery methods(P=0.001).Conclusion: Factors such as different degrees of PF and various postoperative managements are excluded.Patients with NPT experienced much higher possibilities of the occurrence of PF after a surgery than patients with other pancreatic diseases.In this way,the surgery treatment of NPT should be greatly noticed.