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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178 min(120～360 min),中位术中失血量为300 m(l150～600 ml),术后中位进食时间为5 d(3～8 d)。随访中位时间为390 d(120～712 d),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。
Objective To summarize the therapeutic effect of Roux-en-Y anastomosis of pancreas fistula in the treatment of pancreatic duct rupture syndrome. Methods The clinical data of 5 patients with pancreatic duct rupture syndrome treated by Roux-en-Y pancreatic fistula jejunum in our hospital from March 2002 to July 2010 were retrospectively analyzed. The curative effect and complications were analyzed . Results All the 5 patients were treated with acute hemorrhagic necrotizing pancreatitis after operation. The MRCP was diagnosed as pancreatic duct rupture syndrome. The operation mode was Roux-en-Y fistula jejunostomy. The median operative time was 178 min (120 ~ 360 min). The median blood loss was 300 m (l 150 ~ 600 ml) and the median time to eating was 5 d (3-8 d). The median follow-up time was 390 days (120-712 days), and 5 patients recovered well. Two cases of incision infection, the incision was cured; one case of pancreatic and intestinal anastomotic leakage, conservative treatment and cure. Conclusions From this group of limited case data, pancreatic fistula jejunum Roux-en-Y anastomosis is a safer treatment of pancreatic duct rupture syndrome.