• 南充市中心醫(yī)院,川北醫(yī)學院第二附屬醫(yī)院肝膽外科(四川南充 637000);

目的  總結(jié)胰腺瘺管空腸Roux-en-Y吻合術(shù)治療胰管離斷綜合征的治療效果。
方法  回顧性分析2002年3月至2010年7月期間我院行胰腺瘺管空腸Roux-en-Y吻合術(shù)治療的5例胰管離斷綜合征患者的臨床資料,分析其治療效果及手術(shù)并發(fā)癥。
結(jié)果  5例患者均為急性出血壞死性胰腺炎手術(shù)治療后,經(jīng)MRCP確診為胰管離斷綜合征,手術(shù)方式為瘺管空腸Roux-en-Y吻合術(shù),中位手術(shù)時間為178min(120~360min),中位術(shù)中失血量為300ml(150~600ml),術(shù)后中位進食時間為5d(3~8d)。隨訪中位時間為390d(120~712d),5例患者恢復順利。2例患者切口感染,經(jīng)切口換藥治愈;1例患者出現(xiàn)短暫的胰腸吻合口漏,經(jīng)保守治療治愈。
結(jié)論  從本組有限的病例資料看,胰腺瘺管空腸Roux-en-Y吻合術(shù)是胰管離斷綜合征較安全的治療方式。

引用本文: 馬海,田云鴻,楊紅春,王宇. 瘺管空腸Roux-en-Y吻合術(shù)治療胰管離斷綜合征(附5例報道). 中國普外基礎(chǔ)與臨床雜志, 2013, 20(2): 212-213. doi: 復制

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. 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. 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. 3. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula:an international study group (ISGPF) definition[J]. Surgery,.
  4. 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. 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. 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. 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. 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. 9. Telford JJ, Farrell JJ, Saltzman JR, et al. Pancreatic stent placement for duct disruption[J]. Gastrointest Endosc, 2002, 56(1):18-24.
  10. 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. 11. Bassi C, Butturini G, Falconi M, et al. Outcome of open necrosectomy in acute pancreatitis[J]. Pancreatology, 2003, 3(2):128-132.
  12. 12. Ho HS, Frey CF. Gastrointestinal and pancreatic complicationsassociated with severe pancreatitis[J]. Arch Surg, 1995, 130(8):817-823.
  13. 13. Martin FM, Rossi RL, Munson JL, et al. Management of pancreaticfistulas[J]. Arch Surg, 1989, 124(5):571-573.
  14. 14. , 48(6):1001-1007.
  15. 15. , 138(1):8-13.
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