胰腺切除术后胰瘘的研究进展

胰腺切除术是治疗胰头及壶腹周围良恶性肿瘤的常规术式.虽然胰腺切除技术要求高、难度大,然而在大的、专业的治疗中心,胰十二指肠切除术术后病死率已降至3%以F,不过术后并发症发病率仍高达50%.胰瘘一直是最常见、最严重的并发症.胰瘘不仅延长住院时间,增加治疗费用,而日往往需要进一步临床干预,甚至危及生命.尽管胰瘘的早期发现和迅速及时合理的治疗是防止其产生严重后果的关键,然而目前还没有统一的胰瘘定义,这非常不利于文献报道的标准化和对不同中心研究结果的客观比较评价.本文就胰瘘定义的演变和胰瘘预防策略作一综述.

Pancreatic fistula after pancreatectomy

Pancreatic resection is the treatment choice for pancreatic malignancy and cer-tain benign pancreatic disorders. Althogh, pancreatic resection requires high techndogy whereas current mortality after a pancreaticoduodenectomy has dropped to below 3 % in expe-rienced high-volume centers and post-operative morbidity is still as high as 50%. At pres-ent, the single most significant cause of morbidity and mortality after pancreatectomy is the development of pancreatic leakage and fistula (PF). The occurrence of a PF increases the length of hospital stay and the cost of treatment, requires additional investigations and proce-dures, and can result in life-threatening complications. Early recognition of a PF and prompt institution of appropriate treatment is critical to the prevention of potentially devastating con-sequences; however there is no universally accepted definition of PF that would allow stand-ardized reporting and proper comparison of outcomes between different centers. The present article reviews the conlept evolution of PF and discusses the current preventive strategies.