胰十二指肠切除术后并发症诊治分析(附154例)

Analysis of decreasing the complications after pancreaticoduodenectomy

目的探讨如何降低胰十二指肠切除术(PD)术后并发症。方法回顾性分析近10年来本科154例行PD病例的临床资料,分为近期组105例,远期组49例。结果术后主要并发症(近期组,18.1%,远期组,32.7%)、胰漏(近期组,4.8%,远期组,16.3%)、手术时间(近期组,213.34±66.98 min,远期组,250.34±67.26 min)、术后平均住院时间(近期组:18.45±7.11 d,远期组:22.76±9.73)d)均有统计学差异(P<0.05),而胆漏、出血、腹腔感染、胃排空延迟、死亡率、再手术率、手术时间、术中失血尽管有差异但无统计学意义。结论胰漏是PD术后并发症关键因素,规范化、专业化手术治疗可有效减少PD术后并发症。

Objective To analyze postoperative complications of pancretoduod-enectomy（PD）.Methods A retrospective review of 154 consecutive patients who underwent PD with pancreaticojejunostomy in recent 10 years was divided into the recent group of 105 cases and the long term group of 49 cases.Results The surgery-related complications was 18.1% in the recent group while was 32.7%in the long term group.The leak rate in the recent group was 4.8% and in the long term group16.3%.The mean operation time in the recent group was 213.34 ±66.98 min and in the long term group 250.34±67.26 min.The mean hospital length of stay after PD was longer in the long term group（22.76 ±9.73）d as compared to the recent group.（18.45 ±7.11 d,P〈0.05）.However there were no significant differences in bile fistula occurrence,.gastrointestinal and intraa-bdominal hemorrhage,gastroparalysis and infection,mortality and reoperation rate,operation time and intaoperative blood loss between the two groups..Conclusion Leakage of pancreatic is the key factor for the postoperative complications of PD,standard treatment,professional operation can effectively reduce the postoperative complications of PD.