胰十二指肠切除术后胰瘘的影响因素研究进展

胰十二指肠切除术(Pancreaticoduodenectomy,PD)是治疗壶腹周围恶性肿瘤、癌前病变和部分良性疾病的标准术式。PD手术切除范围广,吻合口多,手术并发症较多。近年来,PD手术死亡率已经由最初的大于50%下降到目前的小于5%,手术并发症发生率也显著下降。PD术后主要并发症有胰瘘、出血、腹腔感染、胆瘘、乳糜瘘、术后胃排空障碍等。其中,胰瘘是导致PD术后早期死亡的主要原因。本文就影响PD术后胰瘘的全身因素、局部因素和手术相关因素进行综述,为降低PD术后胰瘘发生率提供临床可操作性。

Research progress of factors affecting pancreatic fistula after pancreatoduodenectomy

Pancreaticoduodenectomy(PD)is the standard procedure for treatment of malignant tumors,precancerous lesions and some benign diseases around the ampulla.PD surgery has a wide range of resection,more anastomoses and more complications.In recent years,the mortality rate of PD surgery has dropped from more than the initial 50%to less than 5%,and the incidence of surgical complications has also decreased significantly.The main complications after PD are pancreatic fistula,bleeding,abdominal infection,biliary fistula,chyle,and postoperative gastric emptying disorder.Among them,pancreatic fistula is the main cause of early death after PD.This paper reviews the systemic factors,local factors and surgical related factors of pancreatic fistula after PD,and provides clinical operability for reducing the incidence after PD.