术后胰瘘的临床诊治研究进展

Advances in Clinical Diagnosis and Treatment of Postoperative Pancreatic Fistula

近年来,由于手术及麻醉技术的改进,外科快速康复理论的深入研究及广泛应用,以及围手术期管理方式的改变,胰腺手术死亡率已大大降低。但由于胰腺组织的解剖学结构复杂,手术常涉及多个组织器官,操作复杂、范围广泛,其术后并发症发生率仍较高,其中胰瘘是胰腺手术后常见而严重的并发症,胰瘘发生率高、死亡率高,对患者的预后及术后生存质量造成直接而明显的影响。因此,控制术后胰瘘的发生、对术后胰瘘的有效治疗已成为当前胰腺手术需要解决的重要问题。但由于对胰腺手术后胰瘘不能正确的进行初期评判、或者不能正确选择治疗方案等原因而增加了相关并发症的发生率。文章就术后胰瘘的发病机制、临床表现、诊断及治疗方式等方面进行综述。

In recent years,the mortality rate of pancreatic surgery has been greatly reduced due to the improvement of surgery and anesthesia technology,the in-depth study and wide application of the theory of rapid surgical rehabilitation,and the change of perioperative management.However,because of the complex anatomical structure of pancreatic tissue,the operation often involves multiple tissues and organs,and the operation is complex and extensive,the incidence of complications after pancreatic fistula is still high.Among them,pancreatic fistula is a common and serious complication after pancreatic surgery.The incidence of pancreatic fistula is high and the mortality rate is high,which has a direct and obvious impact on the prognosis and the quality of life of patients after.Therefore,controlling the occurrence of postoperative pancreatic fistula and effective treatment of postoperative pancreatic fistula have become an important problem to be solved in pancreatic surgery.However,the incidence of related complications is increased due to the inability to correctly evaluate the initial stage of pancreatic fistula after pancreatic surgery or to correctly select treatment options.This article reviews the pathogenesis,clinical manifestations,diagnosis and treatment of postoperative pancreatic fistula.