老年胰十二指肠切除术术后并发症分析

An analysis of postoperative complications in aged patients receiving pancreaticoduodenectomy

目的 分析5年来实施的52例老年胰十二指肠切除术术后并发症.方法 52例老年患者实施胰十二指肠切除术,男性32例,女性20例,年龄65～76岁,中位年龄70.5岁.术后病理证实为Vater＇s壶腹癌及十二指肠乳头癌24例,胰腺癌16例,胆管癌12例.结果 全组病死4例（7.7%）.主要并发症包括上消化道出血4例（7.7%）,腹腔内出血4例（7.7%）,多脏器功能衰竭（MOF）3例（5.8%）,急性呼吸窘迫综合征（ARDS）2例（3.8%）,胰瘘3例（5.8%）,胆瘘5例（9.6%）,胃瘫6例（11.5%）,精神障碍8例（15.4%）.结论 MOF是老年患者胰十二指肠切除术术后主要致死并发症,胃瘫和精神障碍发病率高于中青年组.

Objective To analyze the postoperative complications in aged patients receiving pancreaticoduodenectomy. Methods Pancreaticoduodenectomy was employed for the treatment of 52 aged patients. Of the 52 patients with a mean age of 70.5（65-76）, 32 were male and 20 female. Postoperative pathological examination confirmed that 24 patients suffered from Vater,s ampullary and duodenal cancers, 16 from pancreatic carcinoma and 12 from cholangiocarcinoma. Results The mortality was 7.7%. Severe complications included bleeding （upper gastrointestinal tract or abdominal cavity）,MOF, ARDS, postsurgical gastroparasis syndrome（PGS）, mental disorder, pancreaticogastrostomy leak and biliary-enteric anastomotic leak et al. Conclusion MOF is the main lethal complication. Incidence of PGS and mental disorder is high.