胰十二指肠切除术后一种非典型C级术后胰瘘的替代手术
An Alternative Surgery for an Atypical Kind of Grade C Postoperative Pancreatic Fistula Following Pancreaticoduodenectomy.
作者信息
Virgilio Edoardo, LA Torre Marco, Cavallini Marco
机构信息
Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy
Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology "Sapienza", St. Andrea Hospital, Rome, Italy.
出版信息
Anticancer Res. 2017 Jun;37(6):3265-3269. doi: 10.21873/anticanres.11690.
BACKGROUND/AIM: Grade C postoperative pancreatic fistula (POPF) is a life-threatening complication of pancreaticoduodenectomy (PD), with its surgical management remaining under debate. Occasionally, POPF is associated with a compromised anastomotic Roux-limb. Our series focused to this sort of grade C mixed fistula.
PATIENTS AND METHODS
Between April 2004 and March 2014, 5 out of 12 patients with grade C POPF were classified as grade C mixed POPFs. Surgery consisted of associating resection of the anastomotic jejunal segment with resection and closure of the pancreatic stump.
RESULTS
Four patients suffered from a grade C mixed POPF discharging into a single dehiscent site; 1 patient was found with two dehiscent points in all (pancreatic anastomosis and jejunal rim). For all of them, the described surgical procedure resulted in complete recovery.
CONCLUSION
For grade C pancreatico-digestive POPF, resecting anastomotic jejunal segment during dismantling of the pancreatico-digestive anastomosis appears a very promising surgical technique.
背景/目的：C级术后胰瘘（POPF）是胰十二指肠切除术（PD）的一种危及生命的并发症，其手术治疗仍存在争议。偶尔，POPF与吻合的Roux肠袢受损有关。我们的系列研究聚焦于这种C级混合性瘘。
患者与方法
2004年4月至2014年3月期间，12例C级POPF患者中有5例被归类为C级混合性POPF。手术包括切除吻合的空肠段并切除和闭合胰腺残端。
结果
4例患者出现C级混合性POPF，漏入单一裂开部位；1例患者共发现两个裂开点（胰肠吻合口和空肠边缘）。对所有患者而言，所描述的手术操作均实现了完全康复。
结论
对于C级胰-消化道POPF，在拆除胰-消化道吻合口时切除吻合的空肠段似乎是一种非常有前景的手术技术。
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