【摘要】 目的探讨胰十二指肠切除术后迟发性腹腔内出血的原因与处理方法。方法回顾性分析168例施行胰十二指肠切除术的患者中术后腹腔内出血的情况。结果 168例患者中有38例出现腹腔内迟发性出血,发生率为22.6%(38/168);因大出血而再次手术止血11例,发生率6.5%(11/168);再手术的病死率27.3%(3/11);出血的主要原因是合并胰瘘或腹腔感染。结论胰十二指肠切除术后腹腔内出血与胰瘘或腹腔感染密切相关。完善围手术期的处理,预防与及时发现、积极处理胰瘘和腹腔感染可以减少腹腔内迟发性出血的发生。更多还原

【Abstract】 Objective To study the causes and treatment of delayed intra-abdominal hemorrhage after pancreatoduodenectomy(PD).Methods The occurrence of intra-abdominal hemorrhage among the 168 patients undergoing PD was retropectively analyzed.Results Of the 168 post-PD patients,delayed intra-abdominal hemorrhage occured in 38 cases(22.6%,38/168).Eleven patients underwent reoperation due to severe intra-abdominal bleeding,and the mortality rate in reoperated patients was 27.3%(3/11).Pancreatic fistula and abdominal infection were the major causes attributed to bleeding of post-PD patients.Conclusions The delayed intra-abdominal hemorrhage in post-PD patients is closely related with pancreatic fistula and abdominal infection.The incidence of delayed intra-abdominal hemorrhage can be reduced by the improvement of perioperative management,the prevention,early detection,and treatment of pancreatic fistula and abdominal infection.更多还原