闭合性胰腺损伤及术后并发症的防治

目的探讨胰腺损伤的治疗措施及并发症的防治。方法回顾性分析2000年8月至2008年8月收治的35例胰腺损伤的临床资料。术式包括急诊清创修补胰周引流术6例,单纯胰体尾切除术4例,胰体尾联合脾切除术4例,主胰管修补外引流术2例,近端关闭远端行胰腺空肠吻合术4例,胰腺坏死组织清除、引流术3例,胰、十二指肠及胃肠造瘘引流手术4例。结果 29例进行了手术治疗。除1例自动出院外全部治愈;4例并发胰瘘、2例继发腹腔感染和大出血等并发症。结论胰腺损伤术后并发症多,病死率高,合理有效的手术方式、通畅的引流是防治术后并发症的关键。

Blunt Pancreatic Trauma and the Prevention of Postoperative Complications

Objective To explore the surgical treatment and prevention of complications for pancreatic trauma.Methods From August 2000 to August 2008,the clinical data of 35 patients with pancreatic trauma were retrospectively analyzed.Operative procedures included debridement and external drainage in 6 patients,distal pancreatectomy in 4 cases,pancreatic body and tail combined splenectomy in 4 cases,major duct repair and external drainage in 2 cases,proximal end closure and distal pancreatojejunostomy in 4 cases,remomal and drainage of pancreatic necrotic tissues in 3 cases.pancreas,duodenum and gastrointestinal fistula drainage in 4 cases.Results 29 patients underwent surgical treatment,of whom 28 patients were cured and 1 patient automatically discharged from hospital before cure.Among the 28 patients,4 had complications of pancreatic fistula,2 patients developed abdominal cavity infection and hemorrhea.Conclusion There are high rates of complication and mortality of postoperative pancreatic trauma patients.A thorough and effective surgical procedure and postoperative unobstructed drainage may be the key to reduce complications.