老年人胰十二指肠切除术后并发症的临床分析

Clinical analysis of postoperative complications in elderly after pancreaticoduodenectomy

目的探讨老年人胰十二指肠切除术（PD）后主要的并发症及防治方法。方法回顾性分析我院采用PD术治疗的61例老年人胰胆管疾病患者的临床资料。结果术后并发症发生率为29．51％（18／61），死亡率为3．28％（2／61）。主要并发症为胰瘘2例（3．28％），上消化道出血3例（4．92％），腹腔内感染10例（16．39％），腹腔内出血3例（4．92％），胃瘫6例（9．84％）。结论胰瘘、出血、腹腔内感染及胃瘫是PD术后主要的并发症，术前正确的评估、适宜的胰肠吻合方式、术中精细合理的操作和中西医结合积极处理相关并发症能有效地减少老年人PD后并发症的发生率。

Objective To discuss the prevention and treatment of postoperative complications in elderly after panereatieoduodeneetomy （ PD ）. Methods The clinical data of 61 elderly patients （ 34 males and 27 females） undergoing PD were retrospectively reviewed. The incidence of complications and the prevention experience were analyzed. Results The incidence rate of postoperative complications was 29.51% （18/61）, and the mortality rate was 3.28% （2/61）. The main complications were pancreatic fistula in 2 cases （3.28%） , upper gastrointestinal bleeding in 3 （4.92%） , intra - abdominal infections in 10 （ 16.39% ）, abdominal bleeding in 3 （4.92%）, and gastroplegia in 6 （9.84%）. Conclusion The main postoperative complications after PD include pancreatic fistula, bleeding,intra - abdominal infection, and gastroplegia. Correct preoperative evaluation, appropriate method of panereatieojejunostomy, fine and reasonable intraoperative management, and active integrated traditional and western medical treatment of complications can effectively reduce the incidence of postoperative complications in elderly after PD.