胰十二指肠切除术后并发症的再手术处理:附12例报告
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肖卫东E-mail:frankxwd@126.com

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Reoperation in management of postoperative complications of pancreaticoduodenectomy:Report of 12 Cases 
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    摘要:

    目的:总结再手术处理胰十二指肠切除(PD)术后并发症的经验教训。
    方法:回顾性分析施行的239例PD术的临床资料,分析再手术的原因、处理方式及转归。
    结果:总并发症发生率为30.5%(73/239),病死率为4.6%(11/239)。12例(5.0%,12/239)再手术,其中腹腔内出血6例,切口裂开2例,胰瘘并腹腔感染1例,胰瘘并腹腔内出血1例,胰腺断面出血1例,腹腔感染1例。再手术时间为术后1 h至13 d;再手术病死率为25.0%(3/12)。 
    结论:导致PD术后再手术的主要并发症有出血、胰瘘和切口裂开。及时而果断的再手术是处理PD术后并发症的重要手段,但伴随较高的病死率。

    Abstract:

    Objective:To summarize the experience and lessons of reoperation in management of postoperative complications of pancreaticoduodenectomy (PD). 
    Methods:The cause, surgical procedure and outcome of reoperation in 239 patients undergoing PD between Janunary 2001 and June 2009 were retrospectively analyzed.
    Results:The total mobidity was 30.5% and the mortality was 4.4% in the 239 patients. Twelve (5.0%) patients underwent reoperation, including 6 cases of intra-abdominal hemorrhage, 2 incision dehiscence, 1 pancreatic fistula combined with intra-abdominal infection, 1 pancreatic fistula combined with intra-abdominal hemorrhage, 1 pancreatic cut surface hemorrhage and 1 intra-abdominal infection. The time of reoperation was  1h to 13d postoperatively. The mortality of reoperation was 25.0%.
    Conclusions:Hemorrhage, pancreatic fistula and incision dehiscence are the major causes of reoperation after PD. Timely and decisive reoperation is an important method in management of postoperative complications of PD, but is accompanied with a rather high mortality.

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肖卫东| 蔡军| 李勇| 余永欢| 李学明| 揭志刚| 彭承宏.胰十二指肠切除术后并发症的再手术处理:附12例报告[J].中国普通外科杂志,2010,19(9):969-972.
DOI:10.7659/j. issn.1005-6947.2010.09.004

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  • 收稿日期:2010-02-18
  • 最后修改日期:2010-06-07
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  • 在线发布日期: 2010-09-15