摘要
目的探讨胰十二指肠外伤后手术方式的选择和手术效果。方法对1988~1998年10年间手术治疗的8例胰十二指肠合并伤病人的临床资料进行了回顾性分析。结果①10年间收治胰腺外伤32例,其中胰十二指肠合并伤8例(26%);②术前均未明确诊断,术中1例漏诊;③在十二指肠损伤修补的基础上,行胰腺清创6例,胰腺次全切除1例,胰尾加脾切除1例,其中5例行十二指肠憩室化术。④术后胰瘘4例,十二指肠瘘2例,腹腔感染3例。治愈6例(75%),死亡2例(25%)。结论胰十二指肠损伤术前诊断困难,术中探查仍有漏诊,术后并发症和死亡率高,明确损伤的程度和部位,选择合理的手术方式是提高治愈率降低死亡率的关键。
Objective To study the choice of surgical managements and the result of
operation effec after pancreatoduodenal injuries. Methods Retrospective analysis was
undertaken to study the surgical treatment of 8 patients with pancreatoduodenal injuies in our
department during 19881998. Result 32 cases with traumatic pancreatic injuries were admitted
our department during 19881998.There were 8 cases with combined panceatoduodenal injuries
among these patients(26%).The definite diagnosis of these 8 cases be established before
operation.Discharge diagnosis occurred in 1 case(12.5%) during exploratory lapaotomy.based
on duodenal injuries,pancreatic debridement were operated in 6 cases,partial pancreectomy in
1 case, caudak pancreaticosplenic excision in 1 case and duodenal diverticulization in 6 cases.
Pancreatic fistulas occurred in 4 cases, duodenal fistulas in 2 cases and intraabdominal
abscess in 3 cases after operation.6 cases(75%) were cured;2 cases (25%) died. Conclusion
Right diagnosis of preoperational injuries was very difficulty,the complication and mortality
rate after operations were relatively high.Finding out the position and the degree of injunies to
select a rensonable surical treatment is the Rey step to improve the rate of recovery and to
reduce the complication.
出处
《肝胆外科杂志》
1999年第2期108-109,共2页
Journal of Hepatobiliary Surgery
关键词
胰腺
十二指肠
外伤
外科治疗
PancreasDuodenumTraumaSurgeryTreatmentof combined
pancreatoduoden