临床外科杂志 ›› 2019, Vol. 27 ›› Issue (12): 1021-1023.doi: 10.3969/j.issn.1005-6483.2019.12.003

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急诊胰十二指肠切除治疗严重胰头十二指肠外伤

  

  1. 710032 西安,第四军医大学西京医院肝胆外科 
  • 出版日期:2019-12-20 发布日期:2019-12-20

Emergency pancreaticoduodenectomy for serious injuries of the pancreas and duodenumn

  1. Department of Hepatobiliary Surgery,Xijing Hospital,Fourth Military Medical University,Shaanxi,Xi'an 710032,China
  • Online:2019-12-20 Published:2019-12-20

摘要: 目的 探讨急诊胰十二指肠切除治疗严重胰头十二指肠外伤的手术时机、操作技巧、治疗效果。方法 严重胰头十二指肠外伤病人7例,均行急诊胰十二指肠切除,联合肝破裂修补、右半结肠切除1例,联合左肾、脾切除1例。结果 手术均顺利完成,2例病人术后出现胆漏,经保守治疗而愈。无腹腔严重感染、胰肠吻合口漏、出血等并发症,没有二次手术和手术死亡,所有病人均恢复正常饮食康复出院。结论 对无法修复的严重胰头十二指肠外伤病人,急诊胰十二指肠切除可考虑为一种有效的治疗措施 。

关键词: 胰十二指肠切除术, 胰肠吻合, 胰腺外伤, 胰漏

Abstract: Objective To explored the operation opportunity,operation skill and therapeutic effect of emergency pancreaticoduodenectomy for severe pancreaticoduodenal trauma.Methods Seven patients with severe pancreaticoduodenal trauma underwent emergency pancreatoduodenectomy,one with liver rupture repair and right hemicolectomy,and one with left  kidney and splenectomy resection.Results All the operations were successfully completed.Two patients had bile leakage after operation,recovered after the conservative treatment.No evere intraabdominal infection,pancreaticointestinal anastomotic leakage,postoperative bleeding and other complications occurred.There were no reoperations and postoperative death occurred.All patients returned to normal diet and discharged from hospital.Conclusions Emergency pancreatoduodenectomy can be considered as an effective treatment for patients with severe pancreaticoduodenal trauma which can not be cured by other methods.

Key words: emergency pancreaticoduodenectomy, pancreaticojejunostomy, pancreatic trauma, pancreatic leakage

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