胰十二指肠切除术后胰瘘的预防

胰十二指肠切除是治疗胰头及壶腹周围良、恶性疾病的一种复杂的手术方式。随着手术技术的改进和术后管理的提高,已经使胰腺切除术后死亡率减少到5%以下,然而术后并发症的发生率却改变很小,仍然在30%-40%范围。术后胰瘘依然是胰十二指肠切除术后最常见、最严重的并发症。捆绑式胰肠吻合作为一种安全、有效的吻合方式,能改变术后胰瘘的发生。胰管支撑引流可减少术后胰瘘的发生。生长抑素及其类似物的应用也可减少术后胰瘘的发生。

The prevention of pancreatic fistula after pancreaticoduodenectomyWu Chuan-you Liu Chang-an Li Sheng-wei

Pancreaticoduodenectomy is a complex procedure commonly performed for benign and malignant diseases of the pancreatic head or periampullary region. Advances in surgical techniques and perioperative management have reduced the mortality rates after pancreatic resection to 5%; however, the morbidity rates have changed little, and still range from 30% to 40 % . A postoperative pancreatic fistula is the most common and serious complication after pancreaticoduodenectomy. Binding PJ is a safe and secure technique that improves the rate of pancreatic fistula. The drainage of pancreatic duct with stent could reduce postoperative pancreaticfistula.The use of Somatostatin and its analogs decrease the postoperative pancreatic leakage.