胰十二指肠切除术后发生胰瘘的原因分析

The analysis of factors predisposing to the pancreatic fistula following pancreaticoduodenectomy

目的 分析胰十二指肠切除术后发生胰瘘的相关因素。方法 将 96例病人分为胰瘘组和愈合组。比较两组的年龄、性别、血色素、血红蛋白、血糖、血清胆红素、术中失血量、手术时间的差异 ;比较胰肠端端吻合术和胰肠插入吻合术胰瘘发生率的差异。结果 除胆红素外 ,其余术前指标对胰瘘的发生无明显影响。胰瘘组手术时间明显长于愈合组 (P <0 0 1 ) ,胰肠插入吻合术胰瘘发生率明显低于胰肠端端吻合术 (P <0 0 5 )。结论 胰十二指肠切除术后胰瘘的发生与手术操作有密切关系 ,合理的胰肠吻合方式对降低胰瘘发生率有重要作用。

Objective To determine the factors predisposing to pancreatic fistula following pancreatoduodenectomy. Methods All the 96 patients were divided into pancreatic fistula group and healing group.The possible risk factors were investigated such as age,sex,the level of hemochrome,albumin,blood glucose,serum bilirubin,the volume of operative blood loss and the operationhour.The effects of end to end pancreaticojejunostomy and inserting pancreaticojejunostomy in preventing pancreatic fistula were evaluated. Result All preoperative parameters but serum bilirubin were unable to predispose to pancreatic fistula.The operation hour of pancreatic fistula group were significantly longer than that of healing group( P< 0 01).There was a striking difference in pancreatic fistula between end to end pancreaticojejunostomy and inserting pancreaticojejunostomy( P< 0 05). Conclusion The pancreatic fistula following pancreaticoduodenostomy are mainly influenced by the operation itself.An appropriate mode of pancreaticojejunostomy can play important role in reducing pancreatic fistula incidence.