摘要
目的探讨外伤性胰腺损伤的诊断及外科治疗处理方法。方法对2000年1月～2011年12月收治的24例胰腺外伤的临床资料,包括损伤程度、手术方式、疗效进行回顾性分析。结果Ⅰ级5例,Ⅱ级4例,Ⅲ级7例,Ⅳ级6例,V级2例。非手术治疗5例;手术治疗19例,彻底止血+充分胰周外引流术4例,远端胰腺切除术+脾切除术7例,保留脾脏的远端胰腺切除术2例,胰头近侧断端缝合+远侧断端与空肠Roux-en-Y吻合术4例,十二指肠憩室化手术1例,胰十二指肠切除术1例。死亡2例。结论无明确主胰管损伤、临床情况稳定时,胰腺损伤可先行非手术治疗。手术治疗适于重度闭合性胰腺损伤,根据胰腺损伤的程度选择合理的手术方式可提高治愈率,降低病死率。
Objective To investigate the diagnosis and surgical treatment of traumatic pancreatic injury. Methods Clinical data （from 2000-1 to 2011-12） of 24 patients with pancreatic injury, including injury extent, surgical procedure, efficacy were analyzed retrospectively. Results Grade Ⅰ 5 cases; Grade Ⅱ 4 cases; Grade Ⅲ 7 cases; Grade Ⅳ 6 cases; Grade Ⅴ ：2 cases. 5 cases received nonoperative treatmen. In 19 cases of operation patients, suture and opening of the pancreatic capsule for drainage in 4 cases, 7 cases underwent distal pancreatectomy in combination with splenectomy, 2 pancreatectomy with spleen preservation; pancreatic gland head end closure, far-end jejunum Roux-en-Y tallies in 4 cases, 1 case was operated on using duodenorrhaphy and diverticulization,. 1 underwent the Whipple＇s. 2 patients died. Conclusions In the absence of major pancreatic ductal injury, and the clinical condi- tions were stable, pancreatic injuries can be treated with nonoperative management. Operative treatment is suitable for severe blunt pancreatic injury. Appropriate operation, based on patient condition and the classification of pancrecatic trauma, is the key to increase the cure rate and decrease mortality rate.
出处
《肝胆外科杂志》
2012年第4期269-271,共3页
Journal of Hepatobiliary Surgery
关键词
外伤
胰腺损伤
诊断
治疗
trauma
pancreas injury
diagnosis
treatment
