胰腺损伤的诊断和外科治疗

Diagnosis and surgical treatment of pancreatic trauma

目的 探讨胰腺损伤的诊断和外科治疗。方法 回顾性分析 41例胰腺损伤的临床资料。结果 胰腺损伤 41例中I级 8例 ,II级 16例 ,III级 8例 ,Ⅳ级 5例 ,Ⅴ级 4例。单纯性胰腺损伤 12例 ,合并其他脏器损伤 2 9例 (70 7% )。术前诊断胰腺损伤 7例 ,占17 1%。 41例均行手术治疗。治愈 34例 ,死亡 7例 ,死亡率为 17.1% ,其中 4例死于严重多发伤。发生胰瘘、肠瘘等并发症者 16例 ,占 39 0 %。结论 胰腺损伤的诊断要结合临床资料综合分析判断 ,术中要认真探查。应根据胰腺损伤的情况选择合理的术式 。

Objective To evaluate the diagnosis and surgical treatment of pancreatic trauma(PT). Methods The clinical data of 41 cases of PT admitted into our hospital in recent 10 years were retrospeclively analysed. Results There were 8cases of PT in grade 1, 16 in grade2, 8 in grade 3, 5 in grade 4, 4 in grade 5 in this series. 12 patients had PT only, 29 (70.7%) had PT with other organs injury. Operation was performed on all 41 cases, of them. 34 cases are recovered; 7 died including 4 with multiple injuries. The mortality was 17.1% . There were 16 complications in this series, including fistula of pancreas and intestinal fistula(39.0%). Preoperative correct diagnosis was made only in 7 cases(17.1%). Conclusions The diagnosis of PT needs analysis and determination of all clinical materials. The exploration laparotomy must be done as early as possible. The chioce of operation should be made according to the condition of the PT to improve the survival rate.