胰腺损伤的外科诊治

目的探讨胰腺损伤的诊断与治疗方法。方法回顾性总结58例胰腺损伤病人的临床资料,分析胰腺损伤的诊断方法、损伤程度与手术方式及治疗效果。术前确诊15例,其余均在术中确诊。基本手术方式有胰腺创面清创、缝合,胰腺空肠Roux-Y吻合,改良十二指肠憩室化及胰十二指肠切除手术等。结果治愈47例,术后发生各种并发症15例,死亡11例,其中4例死于严重合并伤,7例死于胰腺损伤后各种并发症。结论重视胰腺损伤的早期诊断,选择合理的术式并及时手术,加强围术期处理,可提高胰腺损伤的救治成功率。

Surgical diagnosis and treatment of pancreas trauma

Objective To research the diagnosis and operative treament of pancreas trauma.Methods The diagnosis,treament and results of 58 cases of pancreas injuries were analyzed.The main operative methods included debriding the damaged pancreas tissue and suture,Roux-Y type pancreas jejunumostomy,refine technique operation for duodenal diverticulum and pancreatoduodenectomy.Results Forty-seven cases recovered and 11 died,which included 4 associated in juries and 7 cases complications of the postoperations.There were 13 complications including fistula and peritoneal infections et al.Conclusion The current diagnosis,prompt operation,to choose a proper operation method according to the condition of the pancreatic injury and to reinforce the perioperative period management can elevate successful rate.