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中华普外科手术学杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 427 -429. doi: 10.3877/cma.j.issn.1674-3946.2019.04.034

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综述

胰体尾切除术后胰瘘防治研究进展
李国庆1, 陈华1,(), 孙备1   
  1. 1. 150001 哈尔滨医科大学附属第一医院胰胆外科
  • 收稿日期:2018-11-02 出版日期:2019-08-26
  • 通信作者: 陈华

Progress in the prevention and treatment of pancreatic fistula after distal pancreatectomy resection

Guoqing Li1, Hua Chen1,(), Bei Sun1   

  1. 1. The First Affiliated Hospital of Harbin Medical University, Harbin 150000, China
  • Received:2018-11-02 Published:2019-08-26
  • Corresponding author: Hua Chen
  • About author:
    Corresponding author: Chen Hua, Email:
引用本文:

李国庆, 陈华, 孙备. 胰体尾切除术后胰瘘防治研究进展[J]. 中华普外科手术学杂志(电子版), 2019, 13(04): 427-429.

Guoqing Li, Hua Chen, Bei Sun. Progress in the prevention and treatment of pancreatic fistula after distal pancreatectomy resection[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(04): 427-429.

胰体尾切除术(DP)较胰十二指肠切除术后胰瘘发生率更高,胰瘘的有效防治是保障胰体尾切除术后安全的关键。诸多危险因素可以导致DP术后胰瘘的发生,具体划分为非技术因素和技术因素两个部分。但目前关于DP术后胰瘘危险因素的分析多为回顾性研究,且研究结果差异性较大,目前尚无统一的DP术后胰瘘的危险因素或预测模型。胰瘘的预防和治疗一直是胰腺外科关注的热点和焦点。预防DP术后胰瘘包括诸多措施,如胰腺断面处理方式及主胰管结扎等,胰瘘发生后的基础治疗主要有抑酸,抑酶,抗炎等。DP术后如何减少胰瘘,仍然是一个挑战。

The incidence of pancreatic fistula after distal pancreatectomy(DP) surgery is higher than that after pancreaticoduodenectomy. The effective prevention and treatment of pancreatic fistula is the key to guarantee the safety after DP surgery. Many risk factors can lead to pancreatic fistula after DP surgery, which are divided into non-technical factors and technical factors. However, the current analysis of the risk factors of pancreatic fistula after DP surgery is mostly retrospective studies, and the results are quite different. At present, there is no unified risk factor or prediction model for pancreatic fistula after DP surgery. The prevention and treatment of pancreatic fistula has always been the focus of pancreatic surgery. The prevention of pancreatic fistula after DP includes many measures, such as the treatment of pancreatic section and the ligation of main pancreatic duct, and the basic treatment after pancreatic fistula mainly includes acid inhibition, enzyme inhibition and anti-inflammation. How to reduce pancreatic fistula after DP surgery remains a challenge now.

[1]
Hirashita T, Ohta M, Yada K, et al.Effect of pre-firing compression on the prevention of pancreatic fistula in distal pancreatectomy[J]. Am J Surg,2018,216(3): 506-510.
[2]
Diener MK, Seiler CM, Rossion I, et al.Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial[J]. Lancet,2011, 377(9776):1514-1522.
[3]
Knaebel HP, Diener MK, Wente MN, et al. Systematic review and meta-analysis of technique for closure of the pancreatic remnant after distal pancreatectomy[J].Br J Surg,2005, 92(5):539-546.
[4]
Xia T, Zhou JY, Mou YP, et al.Risk factors for postoperative pancreatic fistula after laparoscopic distal pancreatectomy using stapler closure technique from one single surgeon[J]. Plos One,2017,12(2):e0172857-e0172857.
[5]
Ban D, Shimada K, Konishi M, et al.Stapler and nonstapler closure of the pancreatic remnant after distal pancreatectomy: multicenter retrospective analysis of 388 patients[J].World J Surg,2012,36(8):1866-1873.
[6]
吴志明.腹腔镜胰体尾切除术后胰漏的防治进展[J].中国微创外科杂志,2016, 16 (6): 566-569.
[7]
张浩,谭春路,李可洲,等.胰体尾切除术后胰瘘的危险因素分析[J].中国普外基础与临床杂志. 2016,23(2):192-197.
[8]
McMillan MT, Vollmer CM Jr.Predictive factors for pancreatic fistula following pancreatectomy[J]. Langenbeck Arch Surg,2014,399(7):811-824.
[9]
Mendoza AS 3rd, Han HS, Ahn S, et al.Predictive factors associated with postoperative pancreatic fistula after laparoscopic distal pancreatectomy: a 10-year single-institution experience[J]. Surgical Endoscopy,2015,30(2): 649-656.
[10]
Kim H, Jang JY, Son D, et al.Optimal stapler cartridge selection according to the thickness of the pancreas in distal pancreatectomy[J]. Medicine(Baltimore),2016,95(35):e4441-e4441.
[11]
Chang YR, Kang JS, Jang JY, et al.Prediction of Pancreatic Fistula After Distal Pancreatectomy Based on Cross-Sectional Images[J].World J Surg,2017,41(6): 1610-1617.
[12]
Miyasaka Y, Mori Y, Nakata K, et al.Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy[J].Surgery Today,2017,47(4): 416-424.
[13]
Sell NM, Pucci MJ, Gabale S, et al.The influence of transection site on the development of pancreatic fistula in patients undergoing distal pancreatectomy: A review of 294 consecutive cases[J].Surgery,2015,157(6):1080-1087.
[14]
Mech K, Wysocki L, Guzel T, et al. A review of methods for preventing pancreatic fistula after distal pancreatectomy[J]. Polski Przeglad Chirurgiczny,2018,90(2):38-44.
[15]
Distler M, Kersting S, Rückert F, et al.Chronic pancreatitis of the pancreatic remnant is an independent risk factor for pancreatic fistula after distal pancreatectomy[J].BMC Surgery,2014,14(1): 54-54.
[16]
Zhang AB, Wang B, Hu C, et al.Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience[J].Journal of Zhejiang University SCIENCE B,2017,18(6): 532-538.
[17]
Karabicak I, Satoi S, Yanagimoto H, et al.Comparison of surgical outcomes of three different stump closure techniques during distal pancreatectomy[J]. Pancreatology,2017,17(3): 497-503.
[18]
Kawai M, Hirono S, Okada KI, et al.Reinforced staplers for distal pancreatectomy[J].Langenbecks Arch Surg,2017,402(8):1197-1204.
[19]
Kollár D, Huszár T, Pohárnok Z, et al.A Review of Techniques for Closure of the Pancreatic Remnant following Distal Pancreatectomy[J].Dig Surg,2016,33(4): 320-328.
[20]
Uemura K, Satoi S, Motoi F, et al.Randomized clinical trial of duct-to-mucosa pancreaticogastrostomy versus handsewn closure after distal pancreatectomy[J].Br J Surg,2017,104(5):536-543.
[21]
Kawai M, Hirono S, Okada K, et al.Randomized Controlled Trial of Pancreaticojejunostomy versus Stapler Closure of the Pancreatic Stump During Distal Pancreatectomy to Reduce Pancreatic Fistula[J]. Ann Surg,2016,264(1):180-187.
[22]
Weniger M, D’Haese JG, Crispin A, et al.Hartwig, Autologous but not Fibrin Sealant Patches for Stump Coverage Reduce Clinically Relevant Pancreatic Fistula in Distal Pancreatectomy: A Systematic Review and Meta-analysis[J].World J Surg,2016,40(11): 2771-2781.
[23]
Jang JY, Shin YC, Han Y, et al.Effect of Polyglycolic Acid Mesh for Prevention of Pancreatic Fistula Following Distal Pancreatectomy: A Randomized Clinical Trial[J]. JAMA Surg,2017,152(2):150-155.
[24]
高红桥,杨尹默,庄岩,等.胰腺残端处理方式对胰体尾切除术后胰瘘的影响[J/CD].中华普外科手术学杂志:电子版,2009, 3(1): 391-396.
[25]
中华医学会外科学分会胰腺外科学组,中国研究型医院学会胰腺病专业委员会,中华外科杂志编辑部.胰腺术后外科常见并发症诊治及预防的专家共识[J].中华外科杂志,2017,55(5):328-334.
[26]
Yoshioka R, Saiura A, Koga R, et al.Risk factors for clinical pancreatic fistula after distal pancreatectomy: analysis of consecutive 100 patients[J].World Journal of Surgery,2010,34(1):121-125.
[27]
郭石,卜献民,戴显伟.胰体尾切除术后胰瘘的相关性因素分析[J/CD].中华普外科手术学杂志:电子版,2011,5(4):429-434.
[28]
杨明,王春友.胰体尾切除术后胰瘘预防及处理[J].中国实用外科杂志,2015,35(8):834-838.
[29]
Fujino Y.Perioperative management of distal pancreatectomy[J].World J Gastroenterol,2015, 21(11):3166-3169.
[30]
Huan L, Fei Q, Lin H, et al.Is peritoneal drainage essential after pancreatic surgery?:A meta-analysis and systematic review[J].Medicine,2017,96(51):e9245-e9245.
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