目的 总结胰腺瘘管空肠Roux-en-Y吻合术治疗胰管离断综合征的治疗效果。
方法 回顾性分析2002年3月至2010年7月期间我院行胰腺瘘管空肠Roux-en-Y吻合术治疗的5例胰管离断综合征患者的临床资料,分析其治疗效果及手术并发症。
结果 5例患者均为急性出血坏死性胰腺炎手术治疗后,经MRCP确诊为胰管离断综合征,手术方式为瘘管空肠Roux-en-Y吻合术,中位手术时间为178min(120~360min),中位术中失血量为300ml(150~600ml),术后中位进食时间为5d(3~8d)。随访中位时间为390d(120~712d),5例患者恢复顺利。2例患者切口感染,经切口换药治愈;1例患者出现短暂的胰肠吻合口漏,经保守治疗治愈。
结论 从本组有限的病例资料看,胰腺瘘管空肠Roux-en-Y吻合术是胰管离断综合征较安全的治疗方式。
Citation:
马海,田云鸿,杨红春,王宇. Roux-en-Y Internal Drainage of Pancreatic Fistula Tract-Jejunostomy for Disconnected Pancreatic Duct Syndrome (Report of 5 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(2): 212-213. doi:
Copy
Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
1. |
Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992[J]. Arch Surg, 1993, 128(5):586-590.
|
2. |
Fulcher AS, Turner MA, Yelon JA, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreaticduct trauma and its sequelae:preliminary findings[J]. J Trauma,.
|
3. |
Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition[J]. Surgery,.
|
4. |
Pelaez-Luna M, Vege SS, Petersen BT, et al. Disconnected pancreatic duct syndrome in severe acute pancreatitis:clinical and imaging characteristics and outcomes in a cohort of 31 cases[J]. Gastrointest Endosc, 2008, 68(1):91-97.
|
5. |
Lawrence C, Howell DA, Stefan AM, et al. Disconnected pancreatic tail syndrome:potential for endoscopic therapy and results of long-term follow-up[J]. Gastrointest Endosc, 2008, 67(4):673-679.
|
6. |
Tann M, Maglinte D, Howard TJ, et al. Disconnected pancreatic duct syndrome:imaging findings and therapeutic implications in 26 surgically corrected patients[J]. J Comput Assist Tomogr, 2003, 27(4):577-582.
|
7. |
Uomo G, Molino D, Visconti M, et al. The incidence of main pancreatic duct disruption in severe biliary pancreatitis[J]. Am J Surg, 1998, 176(1):49-52.
|
8. |
Tsiotos GG, Luque-de León E, Sarr MG. Long-term outcome of necrotizing pancreatitis treated by necrosectomy[J]. Br J Surg, 1998, 85(12):1650-1653.
|
9. |
Telford JJ, Farrell JJ, Saltzman JR, et al. Pancreatic stent placement for duct disruption[J]. Gastrointest Endosc, 2002, 56(1):18-24.
|
10. |
Howard TJ, Rhodes GJ, Selzer DJ, et al. Roux-en-Y internal drainage is the best surgical option to treat patients with disconnectedduct syndrome after severe acute pancreatitis[J]. Surgery, 2001, 130(4):714-719.
|
11. |
Bassi C, Butturini G, Falconi M, et al. Outcome of open necrosectomy in acute pancreatitis[J]. Pancreatology, 2003, 3(2):128-132.
|
12. |
Ho HS, Frey CF. Gastrointestinal and pancreatic complicationsassociated with severe pancreatitis[J]. Arch Surg, 1995, 130(8):817-823.
|
13. |
Martin FM, Rossi RL, Munson JL, et al. Management of pancreaticfistulas[J]. Arch Surg, 1989, 124(5):571-573.
|
14. |
, 48(6):1001-1007.
|
15. |
, 138(1):8-13.
|
- 1. Bradley EL 3rd. A clinically based classification system for acute pancreatitis. Summary of the International Symposium on Acute Pancreatitis, Atlanta, Ga, September 11 through 13, 1992[J]. Arch Surg, 1993, 128(5):586-590.
- 2. Fulcher AS, Turner MA, Yelon JA, et al. Magnetic resonance cholangiopancreatography (MRCP) in the assessment of pancreaticduct trauma and its sequelae:preliminary findings[J]. J Trauma,.
- 3. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition[J]. Surgery,.
- 4. Pelaez-Luna M, Vege SS, Petersen BT, et al. Disconnected pancreatic duct syndrome in severe acute pancreatitis:clinical and imaging characteristics and outcomes in a cohort of 31 cases[J]. Gastrointest Endosc, 2008, 68(1):91-97.
- 5. Lawrence C, Howell DA, Stefan AM, et al. Disconnected pancreatic tail syndrome:potential for endoscopic therapy and results of long-term follow-up[J]. Gastrointest Endosc, 2008, 67(4):673-679.
- 6. Tann M, Maglinte D, Howard TJ, et al. Disconnected pancreatic duct syndrome:imaging findings and therapeutic implications in 26 surgically corrected patients[J]. J Comput Assist Tomogr, 2003, 27(4):577-582.
- 7. Uomo G, Molino D, Visconti M, et al. The incidence of main pancreatic duct disruption in severe biliary pancreatitis[J]. Am J Surg, 1998, 176(1):49-52.
- 8. Tsiotos GG, Luque-de León E, Sarr MG. Long-term outcome of necrotizing pancreatitis treated by necrosectomy[J]. Br J Surg, 1998, 85(12):1650-1653.
- 9. Telford JJ, Farrell JJ, Saltzman JR, et al. Pancreatic stent placement for duct disruption[J]. Gastrointest Endosc, 2002, 56(1):18-24.
- 10. Howard TJ, Rhodes GJ, Selzer DJ, et al. Roux-en-Y internal drainage is the best surgical option to treat patients with disconnectedduct syndrome after severe acute pancreatitis[J]. Surgery, 2001, 130(4):714-719.
- 11. Bassi C, Butturini G, Falconi M, et al. Outcome of open necrosectomy in acute pancreatitis[J]. Pancreatology, 2003, 3(2):128-132.
- 12. Ho HS, Frey CF. Gastrointestinal and pancreatic complicationsassociated with severe pancreatitis[J]. Arch Surg, 1995, 130(8):817-823.
- 13. Martin FM, Rossi RL, Munson JL, et al. Management of pancreaticfistulas[J]. Arch Surg, 1989, 124(5):571-573.
- 14. , 48(6):1001-1007.
- 15. , 138(1):8-13.