胰十二指肠切除术后胰瘘的预防与治疗

目的探讨胰十二指肠切除术后胰瘘的预防与治疗。方法回顾性分析1995至2005年行胰十二指肠切除术的85例患者的临床资料,对胰瘘的预防与治疗方法进行分析总结。结果胰瘘发生率为12.94%(11/85),其中胰管外引流者1例,内引流者10例;胰瘘的发生与吻合技术、残胰断面的处理以及胰实质的坚硬度、胰管的直径有关;胰管内引流可预防胰十二指肠切除术后胰瘘。结论胰管内引流和良好的胰切面血供是预防胰十二指肠切除术后胰瘘的关键。通畅引流与肠内营养对治疗胰十二指肠切除术后胰瘘有重要作用。

Prophylaxis and treatment of pancreatic fistula secondary to pancreaticoduodenectomy.

Objective To summarize a single center's experience of the prophylaxis and treatment of pancreatic fistula secondary to pancreaticoduodenectomy.Methods The medical records of 85 patients underwent pancreaticoduodenectomy from 1995 to 2005 was analyzed retrospectively,in order to summarize our center's experience of the prophylaxis and treatment of pancreatic fistula.Results The incidence of pancreatic fistula was 12.94%(11/85).The occurrence of pancreatic fistula was related to the technique of pancreaticojejunal anastomosis,management of the residual pancreatic section,flintiness of pancreatic parenchyma and pancreatic duct diameter.Pancreatic duct stenting drainage could prevent pancreatic fistula.Conclusions Pancreatic duct stenting drainage and enough blood supply of pancreatic section edge were of importance to prevent pancreatic fistula after pancreaticoduodenectomy.Effective drainage and enteral nutrition played an important role in the management of pancreatic fistula after pancreaticoduodenectomy.