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括约肌切开术后的病变

[Lesions after sphincterotomy].

作者信息

Raguse T, Lynen F K, Geukens T

出版信息

Acta Chir Belg. 1977 May-Jun;76(3):231-3.

PMID:302546
Abstract

Within the last years 70 transduodenal sphincterotomies at stringent indication have been carried out at the Department of Surgery of the RWTH Aachen. This means 9.2% of all operations caused by cholelithiasis. The lethality was 4.2%. The following postoperative complications where stated: a) the bleeding from the divided duct of sphincter with or without haemobile (1.4%), b) the post-sphincterotomy pancreatitis (9.5%) owing to lesion of the pancreatic duct, c) the retroperitoneal abscess with biliary peritonitis (1.8%), d) insufficiency of the duodenal wall or duodenal fistula (1.9%), e) postoperative disturbances of passage of the transsected sphincter Oddi. The haemorrhagic necrosing pancreatitis, the insufficiency of the duodenal wall, the retroperitoneal abscess and the bleeding postsphincterotomy force us to immediate re-operation, while functional disturbances like a spasm or an oedema are controllable pharmacologically and functionally for a short time.

摘要

在过去几年中,亚琛工业大学外科进行了70例严格指征下的经十二指肠括约肌切开术。这意味着在所有因胆结石引发的手术中占9.2%。致死率为4.2%。术后出现了以下并发症:a)括约肌切开处胆管出血,伴或不伴可移动血凝块(1.4%);b)因胰管损伤导致的括约肌切开术后胰腺炎(9.5%);c)伴有胆汁性腹膜炎的腹膜后脓肿(1.8%);d)十二指肠壁缺损或十二指肠瘘(1.9%);e)经切开的Oddi括约肌术后通道紊乱。出血性坏死性胰腺炎、十二指肠壁缺损、腹膜后脓肿以及括约肌切开术后出血迫使我们立即再次手术,而诸如痉挛或水肿等功能紊乱在短期内可通过药物和功能手段控制。

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