Okamoto Kojun, Koyama Isamu, Hara Kiyoka, Aikawa Masayasu, Okada Katsuya, Watanabe Yukihiro, Miyazawa Mitsuo
Department of Gastroenterological Surgery, Saitama International Medical Center, Saitama Medical University. Saitama, Japan.
JOP. 2015 Jan 31;16(1):50-2. doi: 10.6092/1590-8577/2896.
Treatment of pancreatic fistulae after pancreaticoduodenectomy is extremely important because it determines the patient's postoperative course. In particular, treatment of grade B cases should be conducted in a timely manner to avoid deterioration to grade C.
We report the successful treatment of six cases of postoperative intractable, grade B pancreatic fistulae, in which fistula closure was achieved through the use of tissue adhesive.
Six subjects presented at our hospital with grade B pancreatic fistulae after pancreaticoduodenectomy. In all cases, the drain amylase values were high immediately after the operation, and the replacement of the drain was enforced. Closure of the fistula was performed by pouring tissue adhesive into the fistula from the drain, after the fistula had been straightened.
Closure of the fistula was achieved in all six cases at the first attempt. The average fistula length was 13.2 cm, the average volume of pancreatic fluid discharge just before treatment was 63.3 mL, the average amylase value in the drainage was 40,338.5 IU/L, and the subjects were discharged from hospital an average of 8.8 days after treatment. There were no recurrences after treatment.
Intractable pancreatic fistulae can be effectively treated using the tissue adhesive method.
胰十二指肠切除术后胰瘘的治疗极为重要，因为它决定了患者的术后病程。特别是，B级病例应及时治疗，以避免恶化为C级。
我们报告了6例术后顽固性B级胰瘘的成功治疗，通过使用组织粘合剂实现了瘘管闭合。
6例患者在我院接受胰十二指肠切除术后出现B级胰瘘。所有病例术后引流液淀粉酶值立即升高，并加强了引流管更换。在瘘管伸直后，通过从引流管向瘘管内注入组织粘合剂来实现瘘管闭合。
6例均首次尝试即实现瘘管闭合。瘘管平均长度为13.2 cm，治疗前胰液平均引流量为63.3 mL，引流液中淀粉酶平均值为40338.5 IU/L，患者治疗后平均8.8天出院。治疗后无复发。
使用组织粘合剂方法可有效治疗顽固性胰瘘。
