关键词: 胰体尾切除术, 胰瘘

Abstract:

Prevention and treatment for pancreatic fistula after distal pancreatectomy        YANG Ming，WANG Chun-you. Department of Pancreatic Surgery, Union Hospital，Tongji Medical College，Huazhong University of Science and Technology，Wuhan 430022，China
Corresponding author: WANG Chun-you, E-mail: chunyouwang52@126.com
Abstract    The incidence of pancreatic fistula after distal pancreatectomy is higher. Some of the main risk factors associated with pancreatic fistula after distal pancreatectomy include soft pancreatic texture, smaller pancreatic duct diameter and the handling of the pancreatic stump. Surgical techniques should been selected reasonably according to the pancreas texture and pathology, which is the key to decrease the incidence of pancreatic fistula. The optimal surgical method for a thick or edema pancreas is still a standardized hand-sewn closure technique of the pancreatic remnant. An anastomosis of the remnant to the intestine should be considered to prevent pancreatic fistula in the case of proximal duct obstruction associated with dilatation of the main pancreatic duct. The stapler technique should be recommended as the preferred method of pancreatic stump closure for a soft and flat pancreas. Most cases of pancreatic fistula could be cured by conservative treatment. Effective drainage plays an important role in the management of pancreatic fistula and in prevention of abdominal infection and bleeding. Pancreatic stent placement should be considered on the principle of failure of conservative treatment. Some of cases need fistulojejunostomy for refractory pancreatic fistulas.

Key words: distal pancreatectomy, pancreatic fistula