中国普外基础与临床杂志

中国普外基础与临床杂志

胰十二指肠切除术后胰瘘发生的危险因素及风险预测

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目的 总结胰十二指肠切除术后胰瘘发生的危险因素并探讨胰瘘风险预测系统的临床应用。 方法 复习近年来国内外有关胰十二指肠切除术后胰瘘危险因素及风险预测系统研究的相关文献并进行综述。 结果 胰十二指肠切除术后胰瘘发生的危险因素众多,包括患者自身因素(性别、年龄、基础疾病等)、疾病相关因素(胰腺质地、胰管直径、病理类型等)及手术相关因素(手术时间、术中失血量、吻合方式、胰管引流等)。胰瘘风险预测系统对胰十二指肠切除术后胰瘘发生的预测具有较好的准确度。 结论 胰十二指肠切除术后胰瘘发生最重要的危险因素为胰腺质地软、胰管直径小;胰瘘风险预测系统的临床应用价值大,有助于术后胰瘘的预防。

Objective To summarize risk factors of pancreatic fistula after pancreaticoduodenectomy and to investigate clinical application of pancreatic fistula risk prediction system. Method The literatures of the risk factors and risk prediction of pancreatic fistula after the pancreaticoduodenectomy were collected to make a review. Results There were many risk factors for pancreatic fistula after pancreatoduodenectomy, including the patient’s own factors (gender, age, underlying diseases, etc.), disease related factors (pancreatic texture, diameter of pancreatic duct, pathological type, etc.), and surgical related factors (operation time, intraoperative blood loss, anastomosis, pancreatic duct drainage, etc.). The fistula risk prediction system after the pancreatoduodenectomy had a better forecast accuracy. Conclusions Occurrence of pancreatic fistula after pancreaticoduodenectomy is related to softness of pancreas and small diameter of pancreatic duct. Pancreatic fistula risk prediction system is helpful for prevention of pancreatic fistula after pancreaticoduodenectomy.

关键词: 胰十二指肠切除; 胰瘘; 危险因素; 风险预测

Key words: pancreaticoduodenectomy; pancreatic fistula; risk factor; risk prediction

引用本文: 吴耐, 张蓬波, 任泽强. 胰十二指肠切除术后胰瘘发生的危险因素及风险预测. 中国普外基础与临床杂志, 2018, 25(7): 889-894. doi: 10.7507/1007-9424.201708054 复制

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