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胰、十二指肠切除术后胰瘘的危险因素和治疗
引用本文:杨斌,罗蒙,施维锦.胰、十二指肠切除术后胰瘘的危险因素和治疗[J].上海医学,2001,24(12):743-745.
作者姓名:杨斌  罗蒙  施维锦
作者单位:上海第二医科大学附属仁济医院普外科
摘    要:目的:探讨胰、十二指肠切除术后,胰瘘发生的危险因素,分析治疗成功的关键。方法:胰、十二指肠切除的58例患者分成两组:胰瘘组与无胰瘘组,分别对术前与术中发生的胰瘘因素进行分析,比较。结果:58例中,胰瘘发生率为29.0%(17/58例),总死亡率为13.8%(8/58例),胰兼死亡率为11.1%(2/17例),胰瘘都发生在术后第5天(1-20d),术前低白蛋白血症(<30g/L),壶腹部癌及术中未能置入内支撑管构成危险因素,治疗成功的关键是有效的腹腔引流,合并生长抑素的使用。结论:认识胰瘘发生的危险因素,作出相应处理,减少胰瘘的发生率,是提高胰,十二指肠切除成功的关键。有效的腹腔引流及生长抑素的使用是治疗成功的有效手段。,

关 键 词:  十二指肠切除术  胰瘘  危险因素
修稿时间:2000年2月17日

Risk factors and treatment of pancreatic fistula after pancreaticoduodenectomy.
Yan Bing,Luo Meng,Shi Weijin.Risk factors and treatment of pancreatic fistula after pancreaticoduodenectomy.[J].Shanghai Medical Journal,2001,24(12):743-745.
Authors:Yan Bing  Luo Meng  Shi Weijin
Institution:Yan Bing,Luo Meng,Shi Weijin. Department of surgery,Renji Hospital,Shanghai Second Medical University,Shanghai 200001
Abstract:Objective To appraise the risk factors of pancreatic fistula after pancreaticoduodenectomy and to analyse the key points of successful management. Methods 58 Patients with pancreaticoduodenectomy were divided into two groups, one with pancreatic fistula and another without. Statistical analysis was performed using the SAS statistical package of software. Results Among the 58 cases, the incidence of pancreatic fistula was 29% (17/58), the mortality rate was 13.8% (8/58), while that due to pancreatic fistula was 11.1% (2/17). All cases of pancreatic leakage occurred on the 5th day (1 to 20 days). The risk factors of development of fistula were hypoalbaminemia(<30 g/L) ( P =0.04), ampullary carcinoma ( P =0.042) and non stent placement ( P =0.024). The key points of successful treatment were effective drainage and use of somatostatin. Conclusion The most frequent complications after pancreaticoduodenectomy are pancreatic fistula. Effective drainage and use of somatostatin are the key points in successful management.
Keywords:Pancreaticoduodenectomy  Risk factors  Pancreatic fistula  
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