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Whipple术后CT的系统评估方法:临床病例与问题解决策略

Systematic approach to the post-Whipple CT: clinical cases and problem-solving strategies.

作者信息

Colak Ceylan, Parvinian Ahmad, Mugu Vamshi, Horst Kelly, Hibbert Rebecca, Boyum James, Wald Christoph, Chan Alex

机构信息

Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.

出版信息

Emerg Radiol. 2025 Sep 8. doi: 10.1007/s10140-025-02379-6.

DOI:10.1007/s10140-025-02379-6
PMID:40916031
Abstract

Pancreaticoduodenectomy, also known as the classic Whipple procedure, is the most common surgical treatment for pancreatic adenocarcinoma. Postoperative complications are common and occur in approximately 50% of patients. Prompt detection and management of these complications is vital for improving patient outcomes. As such, radiologists must be familiar with the expected postoperative anatomy in these patients and adept at leveraging optimal imaging techniques to detect complications. This pictorial essay will provide radiologists in all practice settings a systematic approach in the evaluation of the post-pancreaticoduodenectomy CT.

摘要

胰十二指肠切除术,也称为经典的惠普尔手术,是胰腺癌最常见的外科治疗方法。术后并发症很常见,约50%的患者会出现。及时发现和处理这些并发症对于改善患者预后至关重要。因此,放射科医生必须熟悉这些患者术后的预期解剖结构,并善于利用最佳成像技术来检测并发症。这篇图文并茂的文章将为所有医疗机构的放射科医生提供一种评估胰十二指肠切除术后CT的系统方法。

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本文引用的文献

1
The incidence and risk factors of marginal ulcers in the short and medium term in symptomatic post-pancreaticoduodenectomy patients ---- single-center experience.症状性胰十二指肠切除术后患者短期和中期边缘性溃疡的发生率和危险因素----单中心经验。
Am J Surg. 2024 Jul;233:94-99. doi: 10.1016/j.amjsurg.2024.02.025. Epub 2024 Feb 13.
2
Imaging after Pancreatic Surgery: Expected Findings and Postoperative Complications.胰腺手术后的影像学检查:预期结果与术后并发症
Radiographics. 2024 Jan;44(1):e230061. doi: 10.1148/rg.230061.
3
Risk factors for early recurrence in patients with pancreatic ductal adenocarcinoma who underwent curative resection.
胰导管腺癌患者根治性切除术后早期复发的危险因素。
World J Surg Oncol. 2023 Aug 24;21(1):263. doi: 10.1186/s12957-023-03141-3.
4
Imaging assessment after pancreaticoduodenectomy: reconstruction techniques-normal findings and complications.胰十二指肠切除术后的影像学评估:重建技术、正常表现及并发症
Insights Imaging. 2022 Oct 20;13(1):170. doi: 10.1186/s13244-022-01306-4.
5
Is routine CT scan after pancreaticoduodenectomy a useful tool in the early detection of complications? A single center retrospective analysis.胰十二指肠切除术后常规 CT 扫描在早期发现并发症方面是否有用?单中心回顾性分析。
Langenbecks Arch Surg. 2022 Nov;407(7):2801-2810. doi: 10.1007/s00423-022-02599-1. Epub 2022 Jun 25.
6
Post pancreaticoduodenectomy hemorrhage: A retrospective analysis of incidence, risk factors and outcome.胰十二指肠切除术后出血:发病率、危险因素及预后的回顾性分析
Saudi J Gastroenterol. 2020 Aug 18;26(6):337-43. doi: 10.4103/sjg.SJG_145_20.
7
Prediction of Late Postoperative Hemorrhage after Whipple Procedure Using Computed Tomography Performed During Early Postoperative Period.应用术后早期 CT 预测胰十二指肠切除术后迟发性出血
Korean J Radiol. 2018 Mar-Apr;19(2):284-291. doi: 10.3348/kjr.2018.19.2.284. Epub 2018 Feb 22.
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The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After.国际研究小组(ISGPS)术后胰瘘定义与分级的2016年更新:11年后
Surgery. 2017 Mar;161(3):584-591. doi: 10.1016/j.surg.2016.11.014. Epub 2016 Dec 28.
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HPB (Oxford). 2016 Apr;18(4):367-74. doi: 10.1016/j.hpb.2015.10.012. Epub 2016 Jan 29.
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J Gastrointest Surg. 2015 Jun;19(6):1093-100. doi: 10.1007/s11605-015-2795-2. Epub 2015 Mar 11.