胰头十二指肠切除术胰瘘的相关因素

The correlation factor affect pancreatic fistula after pancreatoduodenectomy

目的探讨胰头十二指肠切除术胰瘘发生与残胰处理方法,残胰管处理方式等相关关系。方法回顾分析我院自1990年1月至2006年12月所行67例胰头十二指肠切除术,其中Child法重建66例,Whipple法重建1例,残胰管内置短管引流65例,长管引流2例。结果全组67例均无手术死亡,无胰瘘发生,胆瘘1例,应激性溃疡出血6例。结论胰瘘的发生与胰吻合方式关系不大,残胰管内置引流管能起到时明显降低胰瘘发生作用,而全胃肠外营养(TPN)的使用及生长抑素的应用能起到预防胰瘘发生的作用。

Objective To investigate the correlationship between pancreatic fistula after pancreatoduo- denectomy and the way of dealing with residual pancreas and residual pancreatic duct. Methods 67 patients underwent pancreatoduodenectomy, 66 of whom were performed Child reconstruction and the remaining one pa- tient undergoing Whipple procedure. With regard to the residual pancreatic duct drainage, 65 patients had short- tube drainage, whereas 2 cases were apphed long-tube drainage. Results with 0% mortality and pan- creatic fistula, one cases of biIiary fistula, and six cases of stress ulcer bleeding were found and managed. Con- dnsions The occurrence of pancreatic fistula has little to do with the way of dealling with residual pancreatic. Pancreatic residual duct with drainage tube can significantly reduce occurrence of pancreatic fistula, and the use of TPN and the application of somatostatin can play a preventive role in the occurrence of pancreatic fistula.