Walzel C
Wien Klin Wochenschr. 1977 Jun 10;89(12):406-9.
The incidence of postoperative persistent external fistulae following inflammatory or traumatic lesions of the pancreas has increased over the past years. The choice of the optimum time for surgical rectification of this condition, as well as the operative technique is discussed in this review of the literature and 11 cases treated under our care over the past 15 years. It appears advisable 1) not to wait longer than about 6 weeks to carry out operative closure of the fistula (this period of time being necessary for the fistula to develop by granulation), 2) to undertake fistulo-jejunostomy with long section of the canal of the fistula, if possible, especially when applying the "pull through" method and 3) to place, if possible, the drainage tubing along the gastrocolic ligament, during the initial operation thereby selecting the most advantageous site for the development of any subsequent fistula.
在过去几年中,胰腺炎性或创伤性病变术后持续性外瘘的发生率有所上升。本文通过对文献的综述以及对过去15年中我们所治疗的11例病例的分析,探讨了针对这种情况进行手术矫正的最佳时机选择以及手术技巧。似乎建议如下:1)进行瘘管手术闭合的等待时间不要超过约6周(这段时间是瘘管通过肉芽组织形成所必需的);2)如果可能,对瘘管管道进行长段的瘘管空肠吻合术,尤其是在应用“拖出”法时;3)在初次手术期间,如果可能,将引流管沿着胃结肠韧带放置,从而为后续任何瘘管的形成选择最有利的部位。