胰十二指肠切除术后并发症

１９８５年１月～１９９５年１２月，我院行胰十二指肠切除术１１５例，术后死亡率７０％（８例）。并发症发病率为３７４％（４３例），包括胃排空延迟１９１％（２２例），胰空肠吻合口漏７８％（９例），腹腔脓肿７０％（８例），胆肠吻合口漏６１％（７例），应激性溃疡８７％（１０例）和腹腔内出血７０％（８例）。并发症与高龄，手术时间长和术中大量出血有关，大多数以非手术治疗而愈。当需再次手术，死亡率增加。术后并发症的处理以简单和保守为原则。

Postoperative complications of pancreaticoduodenectomy

From 1985 to 1995 pancreaticoduodenectomy was performed on one hundred and fifteen patients in our hospital. Early postoperative complications occurred in 37.4% of the patients, including delayed gastric emptying (19.1%), pancreaticojejunal anastomatic leak (7.8%), intraabdominal sepsis (7.0%), biliary enteric anastomotic leak (6.1%), stress ulcer (8.7%) and intraabdominal hemorrhage (7.0%). Complications were related to old age, time of operation, and operative blood loss in this series. Most complications can be managed conservatively. Mortality rate was increased when a reoperation was required. In this paper, the incidence, reason and present management strategy of early postoperative complications after pancreaticoduodenectomy were discussed.