Grobmyer S R, Rivadeneira D E, Goodman C A, Mackrell P, Lieberman M D, Daly J M
Department of Surgery, New York Presbyterian Hospital-Joan and Sanford I. Weill Medical College of Cornell University, New York, New York 10021, USA.
Am J Surg. 2000 Aug;180(2):117-20. doi: 10.1016/s0002-9610(00)00423-2.
Pancreatic anastomotic failure has historically been regarded as one of the most feared complications after pancreaticoduodenectomy.
We reviewed our recent experience (59 cases), March 1994 to December 1998, with pancreaticoduodenectomy and compared preoperative and intraoperative characteristics as well as outcomes in those patients who experienced (n = 10) versus those who did not experience a postoperative pancreatic leak (n = 49). Information was retrospectively collected from hospital records, office records, and interviews with patients.
The clinical leak rate in this series was 8.5%. There were no significant differences in preoperative or intraoperative characteristics comparing those with versus those without a postoperative pancreatic leak. Only 1 of 10 patients with a postoperative pancreatic leak required reoperation to manage the leak. Those with a pancreatic leak had more other postoperative complications (median 2 versus 0 complications per patient, P = 0.01) and longer hospital duration compared with those without a leak (median 13 versus 23 days, P<0.01). Overall mortality in the series was 3.4%; no mortalities occurred as a result of a pancreatic leak.
In the 1990s pancreatic anastomotic leak remains a potentially lethal problem after pancreaticoduodenectomy. Pancreatic leakage after pancreaticoduodenectomy is associated with other postoperative complications and a longer hospital stay.
胰腺吻合口漏一直以来都被视为胰十二指肠切除术后最可怕的并发症之一。
我们回顾了1994年3月至1998年12月期间我们近期行胰十二指肠切除术的经验（59例），并比较了发生术后胰漏的患者（n = 10）与未发生术后胰漏的患者（n = 49）的术前和术中特征以及预后情况。信息通过回顾性收集医院记录、门诊记录以及对患者的访谈获得。
本系列的临床胰漏发生率为8.5%。在比较有和没有术后胰漏的患者时，术前或术中特征没有显著差异。10例术后发生胰漏的患者中只有1例需要再次手术来处理胰漏。与未发生胰漏的患者相比，发生胰漏的患者有更多其他术后并发症（每位患者的中位数分别为2例和0例并发症，P = 0.01），住院时间也更长（中位数分别为13天和23天，P<0.01）。本系列的总体死亡率为3.4%；没有因胰漏导致的死亡病例。
在20世纪90年代，胰十二指肠切除术后胰腺吻合口漏仍然是一个潜在的致命问题。胰十二指肠切除术后的胰腺渗漏与其他术后并发症以及更长的住院时间相关。
