Degiannis E, Glapa M, Loukogeorgakis S P, Smith M D
Trauma Directorate, Department of Surgery, Chris Hani Baragwanath Hospital, University of the Witwatersrand Medical School, 7 York Road, Parktown 2193, Johannesburg, South Africa.
Injury. 2008 Jan;39(1):21-9. doi: 10.1016/j.injury.2007.07.005. Epub 2007 Nov 9.
Pancreatic injury can pose a formidable challenge to the surgeon, and failure to manage it correctly may have devastating consequences for the patient. Management options for pancreatic trauma are reviewed and technical issues highlighted.
The English-language literature on pancreatic trauma from 1970 to 2006 was reviewed.
Most pancreatic injuries are minor and can be treated by external drainage. Injuries involving the body, neck and tail of the pancreas, and with suspicion or direct evidence of pancreatic duct disruption, require distal pancreatectomy. Similar injuries affecting the head of the pancreas are best managed by simple external drainage, even if there is suspected pancreatic duct injury. Pancreaticoduodenectomy should be reserved for extensive injuries to the head of the pancreas, and should be practised as part of damage control. Most complications should initially be treated by a combination of nutrition, percutaneous drainage and endoscopic stenting.
胰腺损伤对外科医生而言可能是一项艰巨的挑战，处理不当可能给患者带来灾难性后果。本文回顾了胰腺创伤的处理方法，并突出了技术问题。
回顾了1970年至2006年关于胰腺创伤的英文文献。
多数胰腺损伤程度较轻，可通过外引流治疗。涉及胰体、胰颈和胰尾且怀疑或有直接证据表明胰管断裂的损伤，需行胰体尾切除术。影响胰头的类似损伤，即便怀疑有胰管损伤，单纯外引流是最佳处理方式。胰十二指肠切除术应仅用于胰头广泛损伤，并应作为损害控制的一部分实施。多数并发症最初应通过营养支持、经皮引流和内镜支架置入联合治疗。
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