胰十二指肠切除术后胰瘘发生原因及防治分析

Occurrence reason of pancreatic fistula after pancreaticoduodenectomy and analysis of preventive treatment

目的探讨胰十二指肠切除术(PD)后胰瘘发生原因及其防治方法。方法回顾性分析67例PD患者的临床资料,对其术后发生胰瘘的12例患者进行临床分析。结果 67例PD患者发生术后胰瘘12例,发生率为17.9%。12例胰瘘患者中10例经保守治疗后痊愈,有效率为83.3%,2例患者经二次手术治疗,其中1例患者死亡(8.3%)。结论PD后胰瘘的发生率和病死率仍较高。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术后积极处理相关并发症是减少术后胰瘘的关键因素。

Objective To explore the cause and preventive treatment of pancreatic fistula after pancreaticoduodenectomy（PD）.Methods Clinical data of 67 patients with PD were analyzed retrospectively;clinical analysis of 12 cases with pancreatic after PD were conducted.Results Among the 67 cases of PD,there were 12 cases of postoperative pancreatic fistula with the incidence rate of 17.9%.10 cases in 12 patients with pancreatic fistula were recovered by conservative treatment with the effective rate of 83.3%;the other two cases were on second-time operation,and 1 died with the death rate was 8.3%.Conclusion The incidence and death rate of pancreatic fistula after pancreaticoduodenectomy are still high.Preoperative correct assessment,suitable pancreaticojejunostomy way,reasonable operating and active treatment-related postoperative complications are the key factors to reduce the rate of pancreatic fistula.