胰腺损伤22例的诊断与治疗

The diagnosis and treatment of pancreatic trauma: a report of 22 cases

目的 探讨胰腺损伤的诊断与外科治疗方法。方法 回顾性分析我院 1990年1月～ 1996年 12月 2 2例胰腺损伤术前诊断、手术方法和术后处理。结果 腹腔内出血、腹膜炎、肠梗阻是胰腺损伤的主要临床表现。本组术前行B超检查 15例、X线检查 13例、CT检查 9例、B超和CT联合检查 5例 ,无 1例在术前获得确诊。手术方式 :缝扎和电凝止血 +外引流 8例、内引流 9例、胰体尾切除 2例、胰十二指肠切除和十二指肠憩室化手术各 1例。结论 对胰腺损伤术前诊断困难 ,尤其以肠梗阻为主要症状的患者。应根据胰腺损伤的分类合理选择手术方式。

Objective To investigate the method of diagnosis and choice of treatment for pancreatic trauma .[WT5”HZ] Methods Twenty two patients with pancreatic trauma among 2 136 cases of abdominal injuries was confirmed at laparotomy. A retrospective analysis was made for the diagnosis, surgery and post operative management. Results Intraperitoneal hemorrhage, peritonitis and bowel obstruction were main symptoms of pancreatic trauma. Imaging examination included ultrasonography (US) in 15, CT in 10, X ray in 13, and US plus CT in 5. Nine patients underwent internal drainage, five patients underwent pancreatic repair and external drainage, two cases had distal pancreatectomy, one was treated by duodenal diverticulization and one pancreaticoduodenectomy. Conclusions It is difficult to make preoperative diagnosis of pancreatic trauma, especially when bowel obstruction was main symptom. Proper surgical management is made according to the classification of pancreatic trauma.