胰十二指肠切除术后并发胃排空障碍临床分析:附28例报告

Clinical analysis of functional delayed gastric emptying after pancreatodudenectomy:a report of 28 cases

目的探讨胰十二指肠切除术后胃排空障碍发生的原因、诊断及治疗方法.方法回顾14年间136例行经典胰十二指肠切除术后并发胃排空障碍28例患者的临床资料.主要检查方法为上消化道造影、胃镜.结果136例中并发术后胃排空障碍28例,发生率为20.6%.胃排空障碍发生率与胆红素水平、血糖、十二指肠梗阻、胰瘘及腹腔感染相关.所有病例均经非手术治疗而愈,恢复胃动力时间为14～42d,平均28 d.结论术前高胆红素血症、糖尿病、合并十二指肠梗阻及术后并发胰瘘、腹腔感染者易发生胃排空障碍.

Objective To study the etiology , diagnosis and treatment of functional delayed gastric emptying （ FDGE ） resulting from pancreatoduodeneetnmy. Methods From June , 1990 - June , 2003 , 136 patients received panereatoduodenectomy, whnse clinieal data were retrospectively analyzed. Upper gastrointestinal radiography and endoscopy were the main methods of examination. Results Twenty-eight eases were complicated with FDGE in the 136 patients （20. 6% ） after operation. The occurrence of FDGE was correlated with hyperbilirubinemia, diabetes, duodenal obstruetion , pancreatic fistula and abdominal infection. All patients were cured with eonservative treatment. The reeovery time of gastric motility was 14-42 days, average time was 28 days. Conclusions Hyperbilirubinemia, diabetes, duodenal obstruction , pancreatic fistula amt abdominal infection were the main causes of FDGE.