15例胰十二指肠切除术后胰瘘的诊治分析

目的：探讨降低胰十二指肠切除术后胰瘘发生率的处理措施及胰瘘的治疗方法。方法：15例患者中胰头癌10例，胆总管下段癌4例，慢性胰腺炎1例，均行胰十二指肠切除术、胰管空肠端侧双层吻合胰肠重建。术后2例胰瘘患者行早期手术通畅引流及肠内营养等综合治疗。结果：15例中术后出现胰瘘2例，再手术处理，其中1例因心血管意外猝死，1例合并消化道出血及全身衰竭死亡，其余13例术后均恢复良好。结论：胰十二指肠切除术后胰瘘的早期通畅引流，支持治疗、手术操作的不断改进和经验积累是治疗胰瘘的关键。

The analysis of diagnosis and treatment for pancreatic fistula after pancreatoduodenectomy

Objective: To investigate the ways how to decrease the morbidity of pancreatic fistula after pan-cretoduodenectomy and corresponding therapy. Methods: Double-layered head-by-side anastomosis was applied in 15 cases of pancreatoduodenostomy and pancreatoenteric reconstruction, postoperative pancreatic fistula cases were treated by aggressively early surgery, effective drainage and enteral nutrition. Results: Two cases of pancreatic fistula were occurred amony 15 operative cases and apply reoperation. The rest of patients recovered uneventfully except two in-hospital death. Conclusion: Aggresively early surgery, effective drainage, comprehensive treatment and continual improvement and experience accumulated of operative technique were the key to deal with the postoperative pancreatic fistula.