胰十二指肠切除术后胰腺重建问题的再认识

Reconsideration of pancreatic reconstruction after pancreatoduodenectomy

胰瘘是消化道重建术后最常见、最严重的并发症之一,临床处理困难。只有引流液淀粉酶升高而不影响临床治疗决策改变的A级胰瘘被定义为生化漏,其被认为不是真正意义上的胰瘘,也不是真正的手术并发症。临床医师应将注意力集中于B、C级胰瘘的诊治,减少B、C级胰瘘的发生更具临床价值。胰瘘不是单纯的外科技术性问题,但外科重建质量至关重要。关于胰十二指肠切除术后胰腺残端消化道重建的研究,对于胰腺外科医师来说,机遇与挑战并存。

Pancreatic fistula is one of the most common and serious complications after digestive tract reconstruction.Grade A pancreatic fistula is defined as biochemical fistula only when the drainage fluid amylase level is elevated without affecting clinical decision-making.It is not a true pancreatic fistula,or a real surgical complication.Surgeons should pay more attention to the diagnosis and treatment of B and C pancreatic fistula,and it is more valuable to reduce the occurrence of B and C pancreatic fistula.Pancreatic fistula is not a purely surgical technical problem,but the quality of surgical reconstruction is very important.For pancreatic surgeons,the reconstruction of the pancreatic stump digestive tract after pancreaticoduodenectomy is accompanied by both opportunities and challenges.