摘要
目的探讨胰十二指肠切除术后迟发性C级胰瘘并出血的病因、诊断、治疗和预防。方法总结1例胰十二指肠切除术后迟发性胰瘘(术后5 d)并出血(术后21 d)患者的诊治经验和体会。结果发现胰瘘后第2天开始应用生理盐水经腹腔引流管持续局部冲洗,胰瘘引流量逐渐减少;发现腹腔出血后立即应用肾上腺素盐水经腹腔引流管持续局部冲洗、结合凝血酶局部保留灌注,24 h后出血停止;继续应用生理盐水持续局部冲洗7 d,术后第28天康复出院。结论非手术治疗可成功救治胰十二指肠切除术术后迟发性C级胰瘘并出血。
Objective To investigate the cause,diagnosis,treatment and prevention of delayed pancreatic fistula and hemorrhage after pancreaticoduodenectomy（ PD）. Methods We summarized the experience in dealing with a patient with delayed pancreatic fistula（ postoperative day 5） and hemorrhage（ postoperative day 21） after PD for ampullary carcinoma. Results On the second day after the occurrence of postoperative pancreatic fistula,physiological saline was used for local continuous flushing via the peritoneal cavity drainage tube,resulting in gradually reduction of the drainage from the pancreatic fistula. For the management of postoperative hemorrhage,local continuous flushing of adrenalin saline combined with preserving infusion of thrombin was applied,and the hemorrhage stopped within 24 hours.Then physiological saline flushing was continuously carried out for 7 days. The patient was recovered and discharged from the hospital on the postoperative day 28. Conclusion Non-operative management could successfully cure delayed grade C pancreatic fistula and hemorrhage after PD.
出处
《中华普外科手术学杂志（电子版）》
2015年第1期51-53,共3页
Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)
基金
国家电网公司科技项目(SGHB0000AJJS1400182)~~
关键词
胰十二指肠切除术
胰腺瘘
手术后出血
Pancreaticoduodenectomy
Pancreatic fistula
Postoperative hemorrhage
