摘要
目的探讨胰十二指肠切除术(PD)后各种并发症的原因及其防治方法。方法回顾性分析近3年间行胰十二指肠切除术1 3 9例患者的临床资料;其中根治性手术9 1例,同时有4 3例行联合血管的胰十二指肠切除术。结果术后发生并发症3 8例(2 7.4%),包括上消化道出血1 0例(7.2%),腹腔内出血4例(2.9%),胰漏6例(4.3%),胆漏4例(2.9%),腹腔内感染3例(2.2%),肺部感染5例(3.6%),胃肠吻合口功能障碍6例(4.3%)。本组手术后死亡4例,病死率2.9%。结论出血、胰漏、胆漏和腹腔内感染等是PD术后主要并发症,术中仔细操作并采用合适的吻合方法,术后密切观察和及时积极的处理是减少PD术后并发症和病死率的关键。
Objective To analyse the causes of postoperative complications of pancreatoduodenectomy （ PD ） and study measures for prevention and treatment of the complications. Methods A retrospective study was carried out on the data of 139 cases of pancreatoduodenectomy performed during recent 3 years in our hospital. They included 91 cases of radical resection operation and 43 cases of pancreatoduodenectomy combined with vascular resection. Results There were 38 cases （ 27. 4% ） occurred complications after PD, including 10 cases （ 7. 2 % ） of upper gastrointestinal hemorrhage, 4 cases （ 2. 9 % ） of hemorrhage in the abdominal cavity, and 6 （ 4.3 % ） cases of pancreatic leakage, 4 cases （ 2. 9 % ） of bile duct leakage, 3 （2.2%） cases of intra-abdominal infection ,5 cases （3. 6% ） of puhnonary infection, and 6 cases （4.3%） of functional delayed gastric emptying. Four cases died during the peri-operative period. The overall mortality rate were 2.9 % . Conclusions The main complications after PD were hemorrhage , pancreatic leakage, bile duct leakage and intra-abdominal cavity infection. Meticulons operative technique, the selection of appropriate anastomoses technique, careful observation and timely aggressive management in the postoperative period are the key points to reduce postoperative morbidity and motality rate after PD.
出处
《中国普通外科杂志》
CAS
CSCD
2005年第11期850-852,共3页
China Journal of General Surgery
