胰腺创伤的手术治疗

Classification and Operative Treatment for Pancreatic Trauma

目的报告国内167例胰腺创伤患者的分类及手术治疗情况。方法按Lucas标准分类，Ⅰ度胰腺创伤39例，Ⅱ、Ⅲ、Ⅳ度分别为92例、13例和23例。结果分别施行了胰十二指肠切除（6例）、胰体尾切除（45例）、胰腺挫裂伤修补（74例）、胰腺清创（20例）等手术。全组死亡11例（6．6％），术后并发胰瘘26例（15．6％）、肠瘘6例（3．6％）、腹腔脓肿9例（5．4％）、胰腺假性囊肿9例（5．4％）和其它并发症。结论腹部创伤时要重视胰腺损伤的存在，并强调手术时根据胰腺创伤程度合理选择手术方式是降低胰腺外伤死亡率及并发症率的关键。

objective: To report the classification and operative treatment for 167 patients with pancreatic trauma. Methods The pancreatic traumas were classified according to the standard descrital by Lucas. The injuries of these patients were as follows:Grade Ⅰ,39 patlents; Grade Ⅱ,92; Grade Ⅲ, 13 and Grade Ⅳ,23. Results The opertions included pancreateduodenectomy (6 patients), rsation of they and tail of pancreas(45 Patients), repairment of pancreatic laceration(74 patients), pancreatic debridement (20 patients), and other kinds of operations. Among these 167 patients, 11 died(6. 6 % ). After operation, pancreatic fistula developed in 26 patients(15. 6 % ), 6 had intestinal fistula(3. 6 % ), 9 had abdominal abscess(5. 4 % ), pseudocyst of pancreas developed in 9 petients(5. 4 % ), and other kinds of complications occurred in 19 patients. Conclusion We must pay attention to the existance of pancrerltic trauma in abeominal injury, and strec that rational operation according to the degree of pancreatic trauma is the key to reduce mortality and morbidity.