胰腺手术后引流管拔除指征、时机与胰瘘防治

Indication and optimal timing for the drains removal after pancreatectomy and the prevention and treatment of pancreatic fistula

胰瘘是胰腺手术后最常见也是最严重的并发症之一。为了预防和早期发现术后胰瘘,胰腺手术后通常预防性放置腹腔引流管,但目前其必要性和拔除时机尚有争论,影响因素也较多。临床医师应依据临床情况采取个体化原则具体分析,对于术后胰瘘发生风险较高的病人应留置腹腔引流管,在排除胰瘘发生可能后须早期拔除腹腔引流管,促进病人的快速恢复。

Pancreatic fistula after pancreatectomy is one of the most common and serious complications. In order to prevent and early detect pancreatic fistula, prophylactic intraperitoneal drains are frequently placed in the end of pancreateetomy. According to the present study, controversy still remains regarding the necessity of drains and the optimal timing for the drains removal. It is also influenced by many factors. Clinical doctors should take individualized principles according to the clinical situations. Prophylactic intraperitoneal drains should be placed in the patients with high risk for pancreatic fistula. Once the pancreatic fistula was ruled out, prophylactic intraperitoneal drains should be removed as Soon as possible to promote the fast recovery of the patients.