医源性胰腺损伤引起术后胰瘘分析(11例报告)

Postoperative pancreatic fistula caused by iatrogenic pancreatic injuries(An analysis of 11 cases)

目的探讨医源性胰腺损伤引起术后胰瘘的早期诊断及防治措施。方法回顾性分析1990年1月至2003年12月共收治的11例医源性胰腺损伤引起术后胰瘘患者的临床资料。结果对医源性胰腺损伤认识不足致术中漏诊、未建立充分有效的引流及感染因素是引起术后胰瘘的主要原因。B超、CT和淀粉酶测定是早期诊断的主要手段。早期发现并采用综合治疗是提高术后胰瘘治愈的关键。本组11例都经及时诊治,其中9例非手术方法治愈,2例行手术治愈,无1例死亡。出院后平均随访1年,所有患者均无胰瘘、假性囊肿、脓肿等并发症发生。结论医源性术后胰瘘重在预防,早期诊治是提高疗效关键。

Objective To investigate the measures of the early diagnosis,treatment andprophylaxis for postoperative pancreatic fistula caused by iatrogenic pancreatic injury. Methods FromJanuary 1990 to December 2003, the data of the 11 cases with postoperative pancreatic fistula caused by iatrogenic pancreatic injury were analyzed retrospectively. Results Ultrasonograpby, CT scan andamylase determination of abdominal effusion were the main means for early diagnosis. All patientsconservatively or by surgery were cured by conservative treatment （9cases） and operative treatment（2cases）, and the results were satisfactory. 11 patients were followed up in 1 year, No complieationsof pancreatic fistula, pseudocyst and Abscess were found in all eases.No patient died. ConclusionIatrogenic postoperative pancreatic fistula prevention of is very important.treatment are keys to improve the curative effect.Eary diagnosis and