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社区一级创伤中心的创伤性惠普尔手术:一例病例报告。

Trauma Whipple at a community level 1 trauma center: a case report.

作者信息

Nicholson Jessica A, Nicholson Andrew G, Abd-El-Hafez Mahmoud K, Shah Pankti, Lieser Mark J, Chipko John M

机构信息

Menorah Medical Center Department of General Surgery Residency, HCA Midwest Healthcare System, 5721 W 119th St, Overland Park, KS 66209, United States.

Department of Osteopathic Medicine, Kansas City University, 1750 Independence Ave, Kansas City, MO 64106, United States.

出版信息

J Surg Case Rep. 2025 Aug 29;2025(8):rjaf657. doi: 10.1093/jscr/rjaf657. eCollection 2025 Aug.

DOI:10.1093/jscr/rjaf657
PMID:40894949
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12394121/
Abstract

The Whipple operation is oftentimes considered one of the most challenging and complex abdominal operations, usually reserved for duodenal and hepatopancreatobiliary malignancies. In cases of duodenal and/or pancreatic trauma with disruption of the biliary systems, a Whipple reconstruction can be performed. Such operative traumas are rare and carry with them a high level of morbidity and mortality. This case report presents a challenging 46-day clinical course of a 22-year-old African American female, who suffered multiple gunshot wounds, resulting in severe abdominal injuries. These injuries included a grade 3 duodenal injury, grade 4 pancreatic injury, and a grade 4 renal injury. The patient underwent a staged Whipple operation. Postoperative complications included pancreaticojejunostomy leak, feeding tube leak, and mesenteric bleeding, all of which required surgical and interventional radiology management. After a 46-day hospitalization, the patient was discharged to a rehab facility, achieving an impressive recovery 2 years post-surgery.

摘要

惠普尔手术通常被认为是最具挑战性和复杂性的腹部手术之一,通常用于治疗十二指肠和肝胰胆系统恶性肿瘤。在十二指肠和/或胰腺创伤合并胆道系统破裂的情况下,可以进行惠普尔重建手术。此类手术创伤罕见,且伴有高发病率和死亡率。本病例报告呈现了一名22岁非裔美国女性长达46天的具有挑战性的临床病程,她遭受了多处枪伤,导致严重腹部损伤。这些损伤包括3级十二指肠损伤、4级胰腺损伤和4级肾损伤。该患者接受了分期惠普尔手术。术后并发症包括胰空肠吻合口漏、饲管漏和肠系膜出血,所有这些都需要手术和介入放射学处理。经过46天的住院治疗,患者出院前往康复机构,并在术后2年实现了令人瞩目的康复。

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