关键词: 胰腺颈部断裂伤, 损伤控制外科, 引流

Abstract:

Indication of surgery and operation manner selection after rupture of pancreatic neck        LOU Wen-hui, FANG Yuan. Department of General Surgery, Zhongshan Hospital,Fudan University,Shanghai 200032, China
Coresponding author: LOU Wen-hui,E-mail:lou.wenhui@ zs-hospital.sh.cn
Abstract    To treat the rupture of pancreatic neck，surgeons could first place pancreatic ductal stent through endoscopy. Surgery is indicated if the abdominal pain aggravates. Damage control surgery should be implemented if the circulation is unstable，including tamponading，closing abdominal cavity temporarily and reoperaing later on. Distal pancreatectomy and stump blanket suture will be done when distal pancreas is severely injured；Beger operation is considered when duodenum is intact，if not，surgeons should choose pancreaticojejunostomy，pancreatic duct ligation and stump blanket suture. Damage control principle is also applied if the pancreatic and duodenum is severely injured. Complication include bleeding, fistula and psedocyst formation. Key to the prevention is stopping bleeding thoroughly and draining appropriately. When pseudocyst is less then 5cm, conservative treatment is better, if it enlarges surgeons should implement ultrasound or CT guided drainage or do the surgery 6 or 8 weeks later.

Key words: rupture of pancreatic neck, damage control surgery, drainage