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[重症急性胰腺炎“开放”手术的并发症]

[Complications of the 'open' surgeries for severe acute pancreatitis].

作者信息

Glabay V P, Cridnev O V, Arkharov A V, Bykov A N, Kaprin I A, Muslimov B G

机构信息

Chair of Surgery of Sechenov First Moscow State Medical University of Healthcare Ministry of the Russian Federation, Moscow, Russia, City Clinical Hospital No. 3, Moscow, Russia.

出版信息

Khirurgiia (Mosk). 2017(10):72-76. doi: 10.17116/hirurgia20171072-76.

Abstract

INTRODUCTION

With the unsuccessfulness of an intensive therapy and minimally invasive interventions in severe acute pancreatitis they resort to the 'open' surgical interventions. It is important to know about the classification of complications of such surgeries, the frequency of occurrences, the recognition peculiarities and the determination of a treatment plan for the practical surgery.

AIM

The optimization of the usage of 'open' surgeries for patients with severe acute pancreatitis.

MATERIAL AND METHODS

An 'open' surgery has been performed on 322 patients for 25 years, 102 (31.6%) of them had different complications, 35 (34%) of them died. The intraoperative, early and 'seamed' complications have been allocated. The rational treatment concepts of the complications of 'open' surgeries, which are special for their diversity and paired with tactical and technical difficulties, have been developed.

CONCLUSION

The main reasons for the development of complications of 'open' surgeries for severe acute pancreatitis are the destruction of the wall of the main pancreatic duct, parapancreatitis, the intervention of a hollow organ or a vessel of trunk in a purulent lesion. As a rule, mentioned changes appear due to the long-team course of severe acute pancreatitis.

摘要

引言

在重症急性胰腺炎的强化治疗和微创干预未取得成功时,会采取“开放”手术干预。了解此类手术并发症的分类、发生率、识别特点以及制定实际手术的治疗方案很重要。

目的

优化重症急性胰腺炎患者“开放”手术的使用。

材料与方法

25年间对322例患者进行了“开放”手术,其中102例(31.6%)出现不同并发症,35例(34%)死亡。已区分出术中、早期和“缝合”并发症。针对“开放”手术并发症,因其多样性以及伴有战术和技术难题,已制定出合理的治疗理念。

结论

重症急性胰腺炎“开放”手术并发症发生的主要原因是主胰管壁破坏、胰周炎症、中空器官或主干血管介入脓性病变。通常,上述改变是由于重症急性胰腺炎的长期病程所致。

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