27例胰腺损伤诊治体会

目的　讨论胰腺损伤的诊断方法和治疗措施。方法　对 1 991～ 2 0 0 0年间收治的胰腺损伤患者的临床资料进行回顾性分析。结果　共收治胰腺损伤患者 2 7例 ,均经手术证实 ,其中术前确诊 4例 (占 1 4 .8% ) ,术中确诊 2 3例 (占 85 .2 % )。合并主胰管损伤的胰腺裂伤或断裂 7例 ,合并十二指肠损伤 3例 ,合并门静脉裂伤 1例 ,合并脾破裂 7例 ,合并肝破裂 5例 ,合并其他损伤 1 1例。治愈 2 4例 (占 88.9% ) ,死亡 3例 (占 1 1 .1 % )。结论　胰腺损伤术前诊断困难 ,及早剖腹探查是诊断胰腺损伤的主要方法 ,明确损伤程度和部位 ,选择合理的手术方式是提高治愈率的关键

Diagnosis and treatment of 27 patients with pancreatic injuries

Objective To study the diagnosis and treatment of pancreatitis injuries. Methods Retrospective analysis was performed to study the treatment of the patients with pancreatic injuries during the period of 1991 to 2000. Results Twenty seven patients with pancreatic injuries were admitted to our hospital. The diagnosis was confirmed by surgical operation in all cases. Among them, 4 caese ( 14.8% ) were diagnosed before operation and the remaining ( 85.2% ) were diagnosed during surgery. Seven cases had principal pancreatic duct injuries, 3 superimposted with duodenum injury. On surgery, in addition to the pancreatic trauma itself, portal vein laceration was found in one case, splenic laceration in 7 cases, hepatic rupture in 5 cases, and other associated intra abdominal organs in 11 cases respectively. Among them, 24 cases ( 88.9% ) were cured, 3 cases ( 11.1% ) died. Conclusion Correct diagnosis of pancreatic injury was very difficult before operation. Oone of the important ways to diagnose pancreatic injury is to perform laparotomy early. Correct locating locating the site and the degree of injuries so as to select a reasonable surgical treatment is the key step to reduce the morbidity and mortality.