胰十二指肠切除术后胰瘘出血的研究现状和进展

胰十二指肠切除术是腹部外科最大的手术之一,术后并发症高居不下,其中最凶险的并发症就是胰瘘引起的出血,死亡率高达80%。预防和处理胰瘘出血是胰腺外科的难点,也是胰腺外科医生努力的方向。术后胰瘘出血的发生与胰管直径、胰腺质地、假性动脉瘤、胰肠吻合口瘘及胆肠吻合口瘘等众多因素有关。本文就目前胰十二指肠切除术后胰瘘出血的定义和分级、发生危险因素及预防和治疗策略现状和研究进展做一综述。

Current Status and Progress of Postoperative Pancreatic Fistula Related Hemorrhage after pancreaticoduodenectomy

Pancreaticoduodenectomy (PD) is one of the most technically challenging operations in the surgical field, and the incidence of postoperative complications has still remained high. Postoperative pancreatic fistula (POPF) related hemorrhage is one of the most fatal and severe complications after PD, with a high mortality rate (up to 80%). The management and prevention are of great importance to postoperative pancreatic fistula related hemorrhage. Finding a way to thwart these mechanisms is the goal pancreatic surgeons are striving for. The risk factors of POPF related hemorrhage include pancreatic duct size, pancreatic texture, vascular pseudoaneurysm, pancreaticojejunostomy leak, choledochojejunostomy leak, and so on. This review provides an overview of the current status and research progress of the definition, grading, risk factors, management, and treatment for POPF related hemorrhage.