胰十二指肠切除术后并发症的防治分析(附36例报告)

Prevention and treatment of complications after duodenopancreatectomy

目的分析胰十二指肠切除术后并发症发生原因及防治办法。方法通过分析我院10年间36例接受胰十二指肠切除术的患者的临床资料,分析其术后主要并发症的原因和诊治经验。结果36例中6例出现术后并发症,发生率16.7%,包括胰瘘3例、胆瘘1例、腹腔出血1例、消化道出血1例。死亡2例,死亡率5.6%。结论提出防治胰瘘、胆瘘、腹腔出血、消化道出血及腹腔感染的具体措施。

Objective To analyze the causes of the complications following duodenopancreatectomy and their prevention and treatment. Methods The clinical data of 36 cases receiving duodenopancreatectomy during the last decade were analyzed, including 13 cases of ampullary carcinoma, 8 cases of carcinoma of the pancreas head, 8 cases of distal cholangiocarcinoma, and 7 cases of carcinoma of the duodenal papilla. Results Complications occurred in 6 cases after duodenopancreatectomy including pancreatic fistula in 3 cases, bile duct fistula in 1 case, abdominal cavity hemorrhage in 1 case, and alimentary tract hemorrhage in 1 case, with an incidence rate of postoperative complications of 16.7% and death occurred in 2 cases. Conclusion Adequate measures should be taken to reduce such complications as pancreatic fistula, bile duct fistula, abdominal cavity hemorrhage, alimentary tract hemorrhage and abdominal cavity infection, and these measures include nutri- tional support, careful operation in the surgery with adequate drainage, and careful observation and nursing after the sugery.