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胰十二指肠切除术后乳糜漏的原因分析及治疗方法

Cause analysis and therapeutic methods of chylous leakage after pancreaticoduodenectomy.

作者信息

Ji Weiping, Wang Juan, Song Bin, Zheng Kailian, Ma Hongyun, Nadaf Asaad, Shao Zhuo, Jin Gang

机构信息

Department of General Surgery, Shanghai Chang Hai Hospital, Second Military Medical University, Shanghai, China. E-mail.

出版信息

Saudi Med J. 2014 Nov;35(11):1396-9.

Abstract

OBJECTIVES

To study and analyze the causes of chylous leakage after pancreaticoduodenectomy.

METHODS

We retrospectively analyzed 381 patients who underwent pancreaticoduodenectomy (including pylorus-preserving pancreaticoduodenectomy) in Shanghai Chang Hai Hospital Affiliated to the Second Military Medical University, Shanghai, China between January 2010 and December 2012.  We also studied the relationship between postoperative chylous leakage and age, gender, surgical approach, and the tumor nature.

RESULTS

The chylous leak was placed in 23 patients and the incidence of chylous leakage in patients was 0.6%. There was no significant difference in gender, age and tumor pathological pattern between the chylous leakage group and non-chylous leakage group. The incidence of chylous leakage in patients with N1 grade cancer was significantly higher than that in patients with N0 grade cancer (p=0.001). The incidence of chylous leakage in patients suffering R0 resection was significantly higher than that in patients suffering non-R0 resection (p=0.008). All patients were successfully treated conservatively.

CONCLUSION

The incidence of chylous leakage was 0.6% and the chylous leakage was closely linked with the tumor's grade malignancy and the range of radical resection.

摘要

目的

研究和分析胰十二指肠切除术后乳糜漏的原因。

方法

回顾性分析2010年1月至2012年12月期间在中国上海第二军医大学附属长海医院接受胰十二指肠切除术(包括保留幽门的胰十二指肠切除术)的381例患者。我们还研究了术后乳糜漏与年龄、性别、手术方式和肿瘤性质之间的关系。

结果

23例患者发生乳糜漏,患者乳糜漏发生率为0.6%。乳糜漏组与非乳糜漏组在性别、年龄和肿瘤病理类型方面无显著差异。N1级癌症患者的乳糜漏发生率显著高于N0级癌症患者(p=0.001)。R0切除患者的乳糜漏发生率显著高于非R0切除患者(p=0.008)。所有患者均经保守治疗成功治愈。

结论

乳糜漏发生率为0.6%,乳糜漏与肿瘤恶性程度和根治性切除范围密切相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc20/4362130/77715f6914ee/SaudiMedJ-35-1396-g002.jpg

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