预防胰十二指肠切除术后并发胰胆瘘的体会

目的　探讨胰十二指肠切除术后胰胆瘘的预防。方法　对 1994年 3月 - 2 0 0 1年 11月因恶性肿瘤施行胰十二指肠切除术的 81例病人 ,统一手术方式 ,在胆肠及胰肠吻合口处肠管内置引流管减压。结果　治愈 78例 ,死亡 3例 ,术后无一例胰胆瘘发生。结论　正确而精细的手术操作 ,确保吻合口血运 ,使各吻合口处无压力、无张力 ,是保证吻合口顺利愈合的关键。完善的术前准备及术后处理 ,也是减少胰胆瘘发生的重要因素。

The experience for preventing of the pancreatic and biliary fistula after duodenopancreatectomy

Objectives To prevent the pancreatic and biliary fistula after duodenopancreatectomy.Methods From March 1994 to November 2001, 81 patients were underwent duodenopancreatectomy.Which is a technique for intraluminal loop drainage be introduced, which relieves tension from the anastomosis. Results 78 recovered without any pancreatic and biliary fistula.3 patients died.Conclusions The key point in prevention of postoperative pancreatic and biliary fistula includes operation technique, optimal pre-and-post operative care and especially the technique of intraluminal loop drainage with negative pressure.