Kubyshkin V A, Kriger A G, Vishnevskiĭ V A, Gorin D S, Lebedeva A N, Zagagov S O, Akhtanin E A
Khirurgiia (Mosk). 2012(11):4-7.
11 patients with profuse arrosive intraabdominal bleeding after pancreatic resections were operated on the reason of pancreatic tumor. 9 patients had pancreatoduodenal resections (of the 6 pyloruspreserving), 2 patients had middle pancreatic resections. Bleeding was caused by postoperative pancreonecrosis and suture insufficiency in all cases. The source of bleeding were: vena porta, upper mesenteric and splenic veins, upper mesenteric and common hepatic arteries. 3 patients were relaparotomyzed and the vessel wall was sutured. Nevertheless, they died after bleeding recurrence within 2-3 days. The extirpation of the distal pancreatic stump was performed in 8 patients. Of them 3 patients died of multyorgan failure. The experience permits to consider the distal pancreatic stump the operation of choice by postoperative profuse bleeding.
11例因胰腺肿瘤行胰腺切除术后发生腹腔内大出血的患者接受了手术。9例行胰十二指肠切除术（其中6例保留幽门），2例行胰中段切除术。所有病例出血均由术后胰腺坏死和缝合不充分引起。出血来源为：门静脉、肠系膜上静脉和脾静脉、肠系膜上动脉和肝总动脉。3例患者再次剖腹手术并缝合血管壁。然而，他们在出血复发后2 - 3天内死亡。8例患者进行了胰腺远端残端切除术。其中3例死于多器官功能衰竭。该经验表明，对于术后大出血，可考虑将胰腺远端残端切除术作为首选手术方式。
