Abstract:

The management of postoperative intra-abdominal hemorrhage after pancreaticoduodenectomy        ZHANG Tai-ping，YANG Gang，ZHAO Yu-pei. Department of General Surgery，Peking Union Medical College Hospital，Peking Union Medical College，Beijing 100730，China
Corresponding author: ZHAO Yu-pei，E-mail：zhao8028@263.net
Abstract    Intra-abdominal hemorrhage is one of the most serious postoperative complications after pancreaticoduodnectomy(PD). Due to urgent onset，quick change and severe consequences，it becomes a focus of clinical attention. Clarifying the time of onset，severity，cause and location of intra-abdominal hemorrhage of postoperative PD can help clinicians to choose accurate intervention time and therapy method. Early and mild hemorrhage can be treated conservatively，but reoperation is necessary if it’s severe. The outcome of late hemorrhage is serious, interventional treatment or reoperation should be taken as soon as possible. Meanwhile, clinicians should improve preoperative blood coagulation function, operate carefully and prevent postoperative complications actively, such as pancreatic fistula, to avoid intra-abdominal hemorrhage.

Key words: pancreaticoduodnectomy, intra-abdominal hemorrhage

摘要：

腹腔出血是胰十二指肠切除术（PD）后严重的并发症之一，因起病急、变化快、后果严重，成为备受关注的临床焦点问题。明确PD后腹腔出血时间、程度、原因以及部位有助于临床医生选择合适的干预时机和治疗方式。早期出血且程度较轻的病人可保守治疗，若出血严重、血流动力学紊乱则须果断手术干预；PD后晚期出血后果严重，应尽早行血管介入或手术治疗。同时，应注意术前改善凝血功能、术中仔细操作、术后积极预防胰瘘等并发症以减少PD后腹腔出血的发生。

关键词: 胰十二指肠切除术, 腹腔出血