胰腺癌施行胰头十二指肠切除术后早期并发症,除了一般腹部外科手术并发症外,主要有胰漏(瘘)、胆漏、出血以及胃排空障碍等.如何防治这些致命性的并发症,一直是腹部外科医生关注的重点.本文就作者近年来对上述各种并发症所采取的防治措施进行探讨.1 胰漏为了预防胰漏,文献中已出现20余种方法.大体上包括胰腺残端结扎,胰管栓塞,胰空肠吻合和胰胃吻合等.胰管结扎方法简单,但胰漏发生率高达50%,已淘汰不用.胰管栓塞带来长期胰外分泌不足,需要长期酶替代疗法,而且并非每个病人的胰断端均能找到胰管,目前使用的单位不多.胰胃吻合操作不如胰肠吻合便捷.目前大多医院采用各种胰空肠套入吻合法,其胰漏的发生率仍有5%～ Early complications after pancreaticoduodenectomy for pancreatic cancer, in addition to the general complications of abdominal surgery, there are mainly pancreatic leakage, bile leakage, bleeding, and gastric emptying disorders. How to prevent these fatal Complications have always been the focus of attention of the surgeons in the abdomen. This article discusses the prevention and treatment measures adopted by the authors in recent years.1 Pancreatic leakage To prevent pancreatic leakage, more than 20 methods have appeared in the literature. Including pancreatic stump ligation, pancreatic duct embolization, pancreatic jejunostomy, pancreaticogastric anastomosis, etc. The method of pancreatic duct ligation is simple, but the incidence of pancreatic leakage is as high as 50%, and has been eliminated. Pancreatic duct embolism brings long-term pancreatic exocrine insufficiency and requires long-term Enzyme replacement therapy, and not every patient’s pancreas can find the pancreatic duct, the current use of the unit is not much. Pancreatic and gastric anastomosis is not as fast as the pancreatic intestinal anastomosis. At present most hospitals use a variety of pancreatic jejunal nesting anastomosis, which The incidence of pancreatic leakage is still 5%~