胰体尾切除术后胰瘘防治研究进展

Progress in the prevention and treatment of pancreatic fistula after distal pancreatectomy resection

胰体尾切除术(DP)较胰十二指肠切除术后胰瘘发生率更高,胰瘘的有效防治是保障胰体尾切除术后安全的关键。诸多危险因素可以导致DP术后胰瘘的发生,具体划分为非技术因素和技术因素两个部分。但目前关于DP术后胰瘘危险因素的分析多为回顾性研究,且研究结果差异性较大,目前尚无统一的DP术后胰瘘的危险因素或预测模型。胰瘘的预防和治疗一直是胰腺外科关注的热点和焦点。预防DP术后胰瘘包括诸多措施,如胰腺断面处理方式及主胰管结扎等,胰瘘发生后的基础治疗主要有抑酸,抑酶,抗炎等。DP术后如何减少胰瘘,仍然是一个挑战。

The incidence of pancreatic fistula after distal pancreatectomy(DP) surgery is higher than that after pancreaticoduodenectomy. The effective prevention and treatment of pancreatic fistula is the key to guarantee the safety after DP surgery. Many risk factors can lead to pancreatic fistula after DP surgery, which are divided into non-technical factors and technical factors. However, the current analysis of the risk factors of pancreatic fistula after DP surgery is mostly retrospective studies, and the results are quite different. At present, there is no unified risk factor or prediction model for pancreatic fistula after DP surgery. The prevention and treatment of pancreatic fistula has always been the focus of pancreatic surgery. The prevention of pancreatic fistula after DP includes many measures, such as the treatment of pancreatic section and the ligation of main pancreatic duct, and the basic treatment after pancreatic fistula mainly includes acid inhibition, enzyme inhibition and anti-inflammation. How to reduce pancreatic fistula after DP surgery remains a challenge now.