胰腺损伤的外科处理(附24例报告)

Surgical treatment for pancreatic trauma:a report of 24 cases

目的 探讨胰腺损伤的诊断及外科处理。方法 回顾近 15年来收治的胰腺损伤 2 4例 ,所有病例均行手术治疗。结果 治愈 2 3例 ,治愈率 95 .7%。 13例发生并发症 ,发生率 5 4 .1% ,其中胰瘘 5例 ,腹腔脓肿 2例 ,胰腺假性囊肿 3例。死亡 1例 ,死亡率 4 .3%。结论 胰腺损伤早期诊断困难 ,剖腹探查术是早期诊断最简单可靠的方法。术中应彻底清创止血、保存胰腺功能、充分引流 ,对不同程度、类型损伤采取合适的手术方式 ,力求简捷有效。术后应保持引流通畅 ,积极防治并发症。

Objective To discuss the diagnosis and surgical treatment for pancreatic trauma.?Methods Twenty four cases with pancreatic trauma in late 15 years were reviewed. All cases received surgical treatment. ?Results In the 24 cases, 23 (95.7%) were cured,13(54.1%) developed surgical complications including 5 cases of pancreatic fistulas,2 cases of abdominal abscesses and 3 cases of pancreatic pseudocysts.One case died and the mortality was 4.3%.?Conclusion Early diagnosis for pancreatic trauma is difficult. Exploratory laparotomy is the most simple and effective method for early diagnosis.Thorough debridement and hemostasis, maintainence of pancreatic function, sufficient external drainage and selection of appropriate fashion of operation according to different degree and type of pancreatic traumas are essential. It is important to keep the external drainage fluent and prevent and treat the complications after operations.