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胰切除术

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objectiveto investigate the diagnosis and treatment of traumatic duodenal rupture.methodthe clinical data of 13 patients with traumatic duodenal rupture hospitalized from may 1991 to december 2008 were retrospectively analyzed,and the material cause was automobile accident mainly.resultsin these 13 patients,after hospitalization,6 cases were diagnosed in 3 hours,4 cases were diagnosed in 24~72 hours,and 3 cases were diagnosed after 72 hours.three cases with duodenal cleft repair,2 cases with duodenal ostomy,2 cases with duodenum and jejunum roux-en-y anastomosis,1 case with duodenal diverticular surgery,1 case with meliorative duodenal diverticular surgery,1 case with duodenal broken ends closure and anastomosis of stomach with jejunum,1 case with duodenal distal closure and anastomosis of duodenal local with jejunum,and 2 cases with resections of pancreas duodenum.after the operation,6 cases (46.2%) appeared some complications of wound infection,duodenal fistula,digestive tract hemorrhage,pancreatic fistula,abdomen infection and so on.two cases (15.4%) died from multiple system organ failure and septic shock.conclusionthe early diagnosis and correct operation style selection are the keys for duodenal rupture.

目的:探讨外伤性十二指肠破裂的诊断和治疗方法。方法:回顾分析外伤性十二指肠破裂患者13例临床资料。结果:入院后3 h内确诊6例,24~72 h内确诊4例,72 h后确诊3例。3例行十二指肠裂口修补,2例行十二指肠造瘘,2例行十二指肠空肠roux-en-y吻合,1例行十二指肠憩室化手术,1例行改良十二指肠憩室化手术,1例行十二指肠两断端关闭、胃空肠吻合,1例行十二指肠远端关闭、近端与空肠端侧吻合,2例行胰十二指肠切除术。术后6例(46.2%)出现切口感染、十二指肠瘘、消化道出血、胰瘘或腹腔感染等并发症,2例(15.4%)患者死亡,分别死于多器官系统衰竭和感染中毒性休克。结论:早期诊断与正确的术式选择是成功救治外伤性十二指肠破裂的关键。

Objective To explore the clinical application of laparoscopic distal pancreatectomy in the treatment of tumors in the body or tail of the pancreas.

目的探讨腹腔镜胰体尾切除术(laparoscopicdistalpancreatectomy,LDP)治疗胰体尾肿瘤的临床价值。

Objective:To explore the clinical application of laparoscopic distal pancreatectomy for tumors in the body or tail of the pancreas.

目的:探讨腹腔镜胰体尾切除术(laparoscopic distal pancreatectomy,LDP)治疗胰体尾肿瘤的临床价值。

Objective To explore clinic application of endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy for the treatment of the cholecystic stone combined bile duct disease.

目的 探讨逆行胰胆管造影术联合腹腔镜胆囊切除术对胆囊结石伴胆管病变治疗的临床应用方法 27例胆囊结石伴胆道病变患者,先用ERCP、乳头切开术取石;或ERCP和鼻胆管引流及柱状气囊扩张术治疗,术后3~11天,患者无发热、腹痛,血淀粉酶正常,再按常规四孔法施行LC。

The case number of duodenopancreatectomy,cholecystojejunostomy, cholecystoduodenostomy, gastrojejunostomy, cholecystostomy, choledochoduodenostomy, choledochjejunalostomy, exploration of the common bile duct, and T tube drain were 43, 20, 3, 19, 4, 4, 21, 18, 7 respectively.

行胰十二指肠切除术43例,胆囊空肠吻合术20例,胆囊十二指肠吻合术3例,胃空肠吻合术19例,胆囊造瘘术4例,胆总管十二指肠吻合术4例,胆总管空肠吻合术21例,胆总管探查、T管引流18例,剖腹探查术7例。

AIM: To prevent postoperative pancreatic leakage by applying modified Child pancreaticojejunostomy in pancraticoduodenectomy patients due to severe pancreaticoduodenal injury.

目的:采用改良Child胰肠吻合对胰肠吻合缝合技术进行改进,对严重的胰头、十二指肠损伤患者急诊行胰十二指肠切除术,预防胰漏发生。

METHODS: In two severe pancreaticoduodenal injury patients, pancraticoduodenectomy was performed by modified Child pancreaticojejunostomy with 40 Prolene line continuous suture.

对2例胰十二指肠切除术患者,采用40 Prolene线双层胰肠端端套入式连续吻合。

Objective To explore a simple and effective technique in prevention of pancreatic leakage after pancreatoduodenectomy .

目的 探讨胰十二指肠切除术中简单而有效地预防胰瘘的手术方法。

Accurate operational evaluation and careful operation are also important for pancreatoduodenectomy combined vascular resection.

术中准确的评估,细致的解剖操作,对成功开展合并受侵血管切除的胰十二指肠切除术至关重要。

Methods From January 2003, clinical data of 68 cases of patients underwent pancreatoduodenectomy with insertion and purse-suture technique of pancreas-gastric anastomosis were retrospectively reviewed, the characteristic of this technique as well as its value and feasibility were analyzed .

方法对自2003年1月以来采用插入式荷包胰胃吻合法的68例胰十二指肠切除术患者进行回顾性分析,分析该术式的特点及在预防胰瘘中的价值和可行性。

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