胰腺颈部断裂伤的手术处理

目的：总结与探讨胰腺颈部断裂伤的手术处理。方法：回顾性分析我院从1995年1月至2000年12月收治的17例胰腺断裂伤中13例胰腺颈部断裂伤的手术处理情况，其中2例合并胰头部严重挫伤和十二指肠损伤，行胰十二指肠切除术；4例单纯胰腺断裂或合并轻度胰腺挫伤，行胰头侧断端缝闭，远端胰空肠吻合术；7例合并胰体尾挫伤或脾破裂，行胰头侧断端缝加胰体尾切除及脾切除术，结果：12例治愈，1例死亡为右髋脱位行手法复位时出现麻醉意外。7例发生胰瘘，腹腔感染等并发症，结论：胰腺断裂伤以胰腺颈部为多，手术方法应根据胰腺损伤的情况来选择不同术式。

Surgical procedure for pancreatic transectional injury at the neck of the pancreas

Objective To sum up the experience of surgical interventions for the transectional injury at the neck of pancreas. Methods From Jan. 1995 to Dec. 2000, 17 cases of pancreatic transectional injury were treated, 13 of them who were injured at the neck of the pancreas were analyzed retrospectively here. Two cases with severe injury at the head of the pancreas or duodenum were operated on using pancreatoduodenetomy, 4 cases with pancreas transection or together with mild pancreatic contusion received proximal closure of the pancreas and distal pancreaticojejunostomy, and 7 cases with trauma in pancreatic tail and/or spleen rupture were treated with proximal closure of pancreas plus splenectomy. Results Twelve patients cured, 1 patient died due to anesthetic accident when he was prepared to be treated with manipulative reduction for the dislocation of his right hip join. Seven cases had complications of fistula of pancreas, abscess and etchello. Conclusions Blunt pancreatic transections, generally at the neck of the gland, should be treated with different surgical procedures according to the conditions of the pancreatic trauma.