胰十二指肠切除术后胰瘘合并迟发性腹腔出血的诊治体会

Diagnosis and treatment of pancreatic fistula and delayed hemorrhage after pancreatoduode-nectomy

目的探讨胰十二指肠切除术(PD)后胰瘘合并迟发性腹腔出血的诊治体会。方法总结3例胰十二指肠切除术后胰瘘合并腹腔出血患者的诊治过程及体会。结果 3例胰十二指肠切除术后胰瘘合并迟发性腹腔出血患者中,1例经过DSA介入治疗后痊愈,1例经过DSA介入治疗合并腹腔感染,腹腔清创后行全胰切除,1例经过二次DSA介入栓塞治疗后,再次出血行手术缝扎止血痊愈后出院。结论介入联合手术治疗是PD术后胰瘘合并迟发性腹腔出血的重要手段。

Objective To review the experience for the diagnosis and treatment of pancreatic fistula complicated with delayed intra-abdominal bleeding after pancreaticoduodenectomy. Methods We summarized the experience for the diagnosis and treatment of pancreatic fistula complicated with delayed intra-abdominal bleeding in 3 cases who subjected to pancreaticoduodenectomy. Results Among the three patients who developed pancreatic fistula accompanied with delayed intra-abdominal bleeding after pancreaticoduodenectomy,.one patient was cured with interventional therapy,.one patient was complicated with abdominal infection after interventional therapy and had debridement of abdominal cavity with pancreatectomy,.and the other one was discharged with surgical suture and ligation for rebleeding after two failed endovascular embolization treatment. Conclusion Intervention combined with surgical treatment is an important way for pancreatic fistula complicated with delayed intra-abdominal bleeding after pancreaticoduodenectomy.