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胰十二指肠切除术后胰瘘的高危因素分析及防治对策

李俊杰 李霄 岳树强

引用本文:
Citation:

胰十二指肠切除术后胰瘘的高危因素分析及防治对策

详细信息
  • 中图分类号: R657.5

Analysis of high risks of postoperative pancreaticojejunostomy leakage and its treatment

  • 摘要: 胰肠吻合口瘘(胰瘘)是胰十二指肠切除术后常见的并发症,易引起术后感染和出血,导致二次手术治疗甚至死亡。与胰瘘发生相关的高危因素很多,可分为患者全身因素、疾病相关因素和手术相关因素三个方面。预防并控制胰瘘的发生,进一步降低胰十二指肠切除术后病死率,是普外科医师面临的巨大挑战。本文试就胰肠吻合口瘘相关的高危因素和处理对策进行分析和综述,希望对胰腺外科的临床工作有所帮助。

     

  • [1]Halsted WS.Contributions to the surgery of the bile passa-ges, especially of the common bile duct[J].Boston MedSurg J, 1899, 141:645-654.
    [2]Kaush W.Das carcinom der papilla duodeni and seine radikaleentfernung[J].Beitrage zur Klinishen Chirurgie, 1912, 78:29-33.
    [3]Whipple AO, Parsons WB, Mullins CR.Treatment of carci-noma of the ampulla of Vater[J].Ann Surg, 1935, 102 (4) :763-779.
    [4]Bassi C, Dervenis C, Butturini G, et al.International studygroup on pancreatic fistula Definition.Postoperative pancre-atic fistula:an international study group (ISGPF) definition[J].Surgery, 2005, 138 (1) :8-13.
    [5]Akamatsu N, Sugawara Y, Komagome M, et al.Risk factorsfor postoperative pancreatic fistula after pancreaticoduode-nectomy:the significance of the ratio of the main pancreaticduct to the pancreas body as a predictor of leakage[J].JHepatobiliary Pancreat Sci, 2010, 17 (3) :322-328.
    [6]Wande B, Mark P, Charles M.Risk prediction for develop-ment of pancreatic fistula using the ISGPF classificationscheme[J].WorldJ Surg, 2008, 32 (3) :419-428.
    [7]Butturini G, Daskalaki D, Molinari E, et al.Pancreatic fistula:definition and current problems[J].J Hepatobiliary Pancre-at Surg, 2008, 15 (3) :247-251.
    [8]窦科峰, 季茹.胰腺术后胰瘘的相关进展[J].国际外科学杂志, 2009, 36 (9) :580-582.
    [9]Lin JW, Cameron JL, Yeo CJ, et al.Risk factors and out-comes in post pancreaticoduodenecto-my pancreaticocutaneous fistula[J].Gastrointest Surg, 2004, 8 (8) :951-959.
    [10]Munoz-Bongrand N, Sauvanet A, Denys A, et al.Conser-vative management of pancreatic fistula after panereaticoduo-denectomy with pancreaticogastrostomy[J].J Am CollSurg, 2004, 199 (2) :198-203.
    [11]Shyr YM, Su CH, Wu CW, et al.Does drainage fluid amyl-ase reflect pancreatic leakage after pancreaticoduodenecto-my?[J].World J Surg, 2003, 27 (5) :606-610.
    [12]Choe YM, Lee KY, Oh CA, et al.Risk factors affecting pan-creatic fistulas after pancreaticoduodenectomy[J].World JGastroenterol, 2008, 14 (45) :6970-6974.
    [13]彭淑牖, 刘颖斌.胰十二指肠切除术胰肠吻合口漏的防治措施[J].临床外科杂志, 2004, 12 (4) :199-200.
    [14]Murakami Y, Uemura K, Hayasidani Y, et al.A soft pancre-atic remnant is associated with increased drain fluid pancreat-ic amylase and serum CRP levels following pancreatoduode-nectomy[J].J Gastrointest Surg, 2008, 12 (1) :51-56.
    [15]Lermite E, Pessaux P, Brehant O, et al.Risk factors of pan-creatic fistula and delayed gastric emptying after pancreati-coduodenectomy with pancreaticogastrostomy[J].J AmColl Surg, 2007, 204 (4) :588-596.
    [16]Aranha GV, Aaron JM, Shoup M, et al.Current manage-ment of pancreatic?stula after pancreaticoduodenectomy[J].Surgery, 2006, 140 (4) :561-568.
    [17]Kazanjian KK, Hines OJ, Eibl G, et al.Management of pan-creatic fistulas after pancreatico-duodenectomy:results in437 consecutive patients[J].Arch Surg, 2005, 140 (9) :854-856.
    [18]Hoffman J.Does prior adjuvant chemoradiotherapy lead to asafer pancreatoduodenectomy?[J].Ann Surg Oncol, 2006, 13 (1) :7-9.
    [19]Kang CM, Kim KS, Choi JS, et al.Persona〗experience ofpancreasre reconstruction following pancreaticoduodenecto-my[J].ANZ J Surg, 2006, 76 (5) :339-342.
    [20]Lee SE, Yang SH, Jang JY, et al.Pancreatic fistula afterpancreaticoduodenectomy:a comparison between the twopancreaticojejunostomy methods for approximating the pan-creatic parenchyma to the jejunal seromuscular layer:inter-rupted vs continuous stitches[J].World J Gastroenterol, 2007, 13 (40) :5351-5356.
    [21]Peng SY, Wang JW, Lau WY, et al.Conventional versusbinding pancreaticojejunostomy after pancreaticoduodenecto-my:a prospective randomized trial[J].Ann Surg, 2007, 245 (5) :692-698.
    [22]Bassi C, Falconi M, Molinari E, et al.Duct-to-mucosaversus end-to-side pancreaticojejunost-omy reconstruc-tion after pancreaticoduodenectomy:results of a prospectiverandomized trial[J].Surgery, 2003, 134 (5) :766-771.
    [23]Peng SY, Wang JW, Lau WY, et al.Conventional versusbinding pancreaticojejunostomy after pancreaticoduodenecto-my:a prospective randomized trial[J].Ann Surg, 2007, 245 (5) :692-698.
    [24]Peng SY, Mou YP, Liu YB, et al.Binding pancreaticojejunostomy:150 consecutive cases without leakage[J].JGastrointest Surg, 2003, 7 (7) :898-900.
    [25]岳树强, 杨雁灵, 帝振宇, 等.降落伞式胰管空肠吻合和胆肠吻合在胰十二指肠切除术的应用体会[J].临床外科杂志, 2009, 17 (2) :85-87.
    [26]Yeo CJ, Cameron JY, Maher MM, et al.A prospective ran-domized trial of pancreaticogastos-tomy versus panceatico-jejunostomy after pancreaticoduodenectomy[J].Ann Surg, 1955, 222 (4) :580-592.
    [27]Rosemurgy AS, Bloomston M, Serafini FM, et al.Frequen-cy with which surgeons pancreati-coduodenect omy deter-mines length of stay, hospital charges, and in-hospital mor-tality[J].J Gastrointtest Surg, 2001, 5 (1) :21-26.
    [28]杨雁灵, 徐小平, 昊国强, 等.改良Child胰肠吻合预防胰漏发生[J].临床外科杂志, 2008, 16 (3) :176-178.
    [29]Poon RT, Fan ST, Lo CM, et al.External drainage of pancre-atic duct with a stent to reduce leakage rate of pancreaticoje-junostomy after pancreaticoduodenectomy:a prospectiverandomized trial[J].Ann Surg, 2007, 246 (3) :425-433.
    [30]Imaizumi T, Hatori T, Tobita K, et al.Pancreaticojejunosto-my using duct-to-mucosa anastomosis without a stentingtube[J].J Hepatobiliary Pancreat Surg, 2006, 13 (3) :194-201.
    [31]Winter JM, Cameron JL, Campbell KA, et al.Does pancre-atic duct stenting decrease the rate of pancreatic fistula fol-lowing pancreaticoduodenectomy?Results of a prospectiverandomized trial[J].J Gastrointest Surg, 2006, 10 (9) :1280-1290.
    [32]Khan AW, Agarwal AK, Davidson BR.Isolated Roux Loopduct-to-mucosa pancreaticojejun-ostomy avoids pancre-atic leaks in pancreaticoduodenectomy[J].Dig Surg, 2002, 19 (3) :199-204.
    [33]Sutton CD, Garcea G, White SA, et al.Isolated Roux-looppancreaticojejunostomy:a series of 61 patients with zeropostoperative pancreaticoenteric leaks[J].J GastrointestSurg, 2004, 8 (6) :701-705.
    [34]Kaman L, Sanyal S, Behera A, et al.Isolated roux loop pan-creaticojejunostomy vs single loop pancreaticojejunostomyafter pancreaticoduodenectomy[J].Int J Surg, 2008, 6 (4) :306-310.
    [35]Lai EC, Lau SH, Lau WY.Measures to prevent pancreaticfistula after pancreatoduodenecto-my:a comprehensivereview[J].Arch Surg, 2009, 144 (11) :1074-1080.
    [36]Connor S, Alexakis N, Garden OJ, et al.Metaanalysis of thevalue of somatostatin and its analogues in reducing complica-tions associated with pancreatic surgery[J].Br J Surg, 2005, 92 (9) :1059-1067.
    [37]Alghamdi AA, Jawas AM, Hart RS.Use of octreotide for theprevention of pancreatic fistula after elective pancreatic sur-gery:a systematic review and meta-analysis[J].Can JSurg, 2007, 50 (6) :459-466.
    [38]Nagakawa Y, Tsuchida A, Saito H, et al.The VIO soft coag-ulation system can prevent pancreatic fistula following pan-createctom[J].J Hepatobiliary Pancreat Surg, 2008, 15 (4) :359-365.
    [39]Okano K, Kakinoki K, Yachida S, et al.A simple and safepancreastransection using a stapling device for a distal pan-createctomy[J].J Hepatobiliary Pancreat Surg, 2008, 15 (4) :353-358.
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  • 收稿日期:  2011-06-13
  • 出版日期:  2011-11-20
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