Blom R L G M, van Heijl M, Busch O R C, van Berge Henegouwen M I
Department of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
Case Rep Gastroenterol. 2009 Nov 21;3(3):382-388. doi: 10.1159/000258092.
Postoperative pancreatitis is a rare but devastating complication after esophageal surgery. It has been described in connection with abdominal surgery but the etiology in connection with esophageal surgery has never been evaluated. The present study describes 4 cases of postoperative pancreatitis, and a hypothesis about the etiology is formed. METHODS: We performed a search for patients with postoperative pancreatitis after esophagectomy using our prospective database including all patients that underwent esophageal resection at our institution between 1993 and 2008. Pancreatitis was described as abdominal pain, hyperamylasemia, signs of pancreatitis on CT scan or findings during laparotomy or autopsy. RESULTS: A total of 950 patients underwent esophagectomy at our institution, 4 patients developed postoperative pancreatitis (incidence 0.4%). Two out of four patients died. Discussion: Pancreatitis following esophageal surgery is a serious, potentially lethal complication. Diagnosis can be difficult as clear clinical or laboratory findings might be lacking. Peroperative manipulation of the pancreas, mobilization of the duodenum or compromized vascularization have been suggested as etiological factors; although in the described patients, none of these factors were identified as the cause of pancreatitis. In conclusion, pancreatitis following esophageal surgery is a serious but rare complication that should always be considered in patients who deteriorate postoperatively.
术后胰腺炎是食管手术后一种罕见但极具破坏性的并发症。它已被描述与腹部手术相关，但与食管手术相关的病因从未被评估过。本研究描述了4例术后胰腺炎病例，并形成了一个关于病因的假设。方法：我们使用前瞻性数据库搜索了食管切除术后发生术后胰腺炎的患者，该数据库包括1993年至2008年在我们机构接受食管切除术的所有患者。胰腺炎被描述为腹痛、高淀粉酶血症、CT扫描上的胰腺炎征象或剖腹手术或尸检时的发现。结果：我们机构共有950例患者接受了食管切除术，4例患者发生了术后胰腺炎（发生率0.4%）。4例患者中有2例死亡。讨论：食管手术后的胰腺炎是一种严重的、潜在致命的并发症。由于可能缺乏明确的临床或实验室检查结果，诊断可能会很困难。术中对胰腺的操作、十二指肠的游离或血管化受损已被认为是病因；尽管在所描述的患者中，这些因素均未被确定为胰腺炎的病因。总之，食管手术后的胰腺炎是一种严重但罕见的并发症，对于术后病情恶化的患者应始终予以考虑。
