Diagnosis and Treatment of Pancreatic Trauma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 张升宁 , 李立 , 冉江华 , 刘静 , 李来邦 , 高杨 , 梁宇 , 陈奕明

;

Corresponding author：

张升宁, Email: zsn813@hoatmail.com

Keywords：

胰腺损伤; 诊断; 治疗

DOI：

10.7507/1007-9424.20140022

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探讨胰腺损伤的诊断和治疗方法。方法回顾性分析16例胰腺损伤患者的临床资料。结果胰腺损伤属Ⅰ级3例，Ⅱ级5例，Ⅲ级4例，Ⅳ级3例，Ⅴ级1例；系单纯胰腺损伤3例，合并其他器官损伤13例。术前确诊为胰腺损伤者9例，另7例分别诊断为：脾破裂1例，肝破裂1例，开放性腹部损伤2例，空腔脏器穿孔、弥漫性腹膜炎3例。8例胰腺Ⅰ～Ⅱ级损伤者行清创、缝扎止血及胰腺周围双套管引流术；4例Ⅲ级损伤者行胰体尾切除+脾切除术；3例Ⅳ级损伤者，行近端胰腺断端缝合、胰管缝扎加胰体尾空肠Roux-en-Y吻合术；对1例Ⅴ级损伤者行胰十二指肠切除术。术后发生胰瘘5例；治愈13例，死亡3例。结论早期诊断、及时手术探查以及术中选择合理的手术方式，对降低胰腺损伤的并发症和死亡率和改善胰腺损伤的预后均十分重要。

Citation： 张升宁, 李立, 冉江华, 刘静, 李来邦, 高杨, 梁宇, 陈奕明. Diagnosis and Treatment of Pancreatic Trauma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(1): 98-100. doi: 10.7507/1007-9424.20140022 Copy

1.	Khan MA, Cameron I.The management of pancreatic trauma[J].J R Army Med Corps, 2010, 156(4):221-227.
2.	Moore EE, Cogbill TH, Malangoni MA, et al.Organ injury sca-ling, Ⅱ:pancreas, duodenum, small bowel, colon, and rectum[J].J Trauma, 1990, 30(11):1427-1429.
3.	Tan KK, Chan DX, Vijayan A, et al.Management of pancreatic injuries after blunt abdominal trauma.Experience at a single insti-tution[J].JOP, 2009, 10(6):657-663.
4.	Degiannis E, Glapa M, Loukogeorgakis SP, et al.Management of pancreatic trauma[J].Injury, 2008, 39(1):21-29.
5.	Thomas H, Madanur M, Bartlett A, et al.Pancreatic trauma-12-year experience from a tertiary center[J].Panereas, 2009, 38(2):113-116.
6.	Wong YC, Wang LJ, Fang JF, et al.Multidetector-row computed tomography (CT) of blunt pancreaticinjuries:can contrast-enhanced multiphasic CT detect pancreatic duct injuries?[J].J Trauma, 2008, 64(3):666-672.
7.	Linsenmaier U, Wirth S, Reiser M, et al.Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology[J].Radiographics, 2008, 28(6):1591-1602.
8.	Rekhi S, Anderson SW, Rhea JT, et al.Imaging of blunt panc-reatic trauma[J].Emerg Radiol, 2010, 17(1):13-19.
9.	Ragozzino A, Manfredi R, Scaglione M.The use of MRCP in the detection of pancreatic injuries after blunt trauma[J].Emerg Radiol, 2003, 10(1):14-18.
10.	Bhasin DK, Rana SS, Rao C, et al.Endoscopic management of pancreatic injury due to abdominal trauma[J].JOP, 2012, 13(2):187-192.
11.	Wood JH, Partrick DA, Bruny JL, et al.Operative vs nonoperative management of blunt pancreatic trauma in children[J].J Pediatr Surg, 2010, 45(2):401-406.
12.	Paul MD, Mooney DP.The management of pancreatic injuries in children:operate or observe[J].J Pediatr Surg, 2011, 46(6):1140-1143.
13.	Oláh A, Issekutz A, Haulik L, et al.Pancreatic transection from blunt abdominal trauma:early versus delayed diagnosis and surg-ical management[J].Dig Surg, 2003, 20(5):408-414.
14.	Krige JE, Thomson SR.Operative strategies in pancreatic trauma:keep it safe and simple[J].S Afr J Surg, 2011, 49(3):106-109.
15.	Rogers SJ, Cello JP, Schecter WP.Endoscopic retrograde cholangiopancreatography in patients with pancreatic trauma[J].J Trauma, 2010, 68(3):538-544.
16.	Fisher M, Brasel K.Evolving management of pancreatic injury[J].Curr Opin Crit Care, 2011, 17(6):613-617.

1. Khan MA, Cameron I.The management of pancreatic trauma[J].J R Army Med Corps, 2010, 156(4):221-227.
2. Moore EE, Cogbill TH, Malangoni MA, et al.Organ injury sca-ling, Ⅱ:pancreas, duodenum, small bowel, colon, and rectum[J].J Trauma, 1990, 30(11):1427-1429.
3. Tan KK, Chan DX, Vijayan A, et al.Management of pancreatic injuries after blunt abdominal trauma.Experience at a single insti-tution[J].JOP, 2009, 10(6):657-663.
4. Degiannis E, Glapa M, Loukogeorgakis SP, et al.Management of pancreatic trauma[J].Injury, 2008, 39(1):21-29.
5. Thomas H, Madanur M, Bartlett A, et al.Pancreatic trauma-12-year experience from a tertiary center[J].Panereas, 2009, 38(2):113-116.
6. Wong YC, Wang LJ, Fang JF, et al.Multidetector-row computed tomography (CT) of blunt pancreaticinjuries:can contrast-enhanced multiphasic CT detect pancreatic duct injuries?[J].J Trauma, 2008, 64(3):666-672.
7. Linsenmaier U, Wirth S, Reiser M, et al.Diagnosis and classification of pancreatic and duodenal injuries in emergency radiology[J].Radiographics, 2008, 28(6):1591-1602.
8. Rekhi S, Anderson SW, Rhea JT, et al.Imaging of blunt panc-reatic trauma[J].Emerg Radiol, 2010, 17(1):13-19.
9. Ragozzino A, Manfredi R, Scaglione M.The use of MRCP in the detection of pancreatic injuries after blunt trauma[J].Emerg Radiol, 2003, 10(1):14-18.
10. Bhasin DK, Rana SS, Rao C, et al.Endoscopic management of pancreatic injury due to abdominal trauma[J].JOP, 2012, 13(2):187-192.
11. Wood JH, Partrick DA, Bruny JL, et al.Operative vs nonoperative management of blunt pancreatic trauma in children[J].J Pediatr Surg, 2010, 45(2):401-406.
12. Paul MD, Mooney DP.The management of pancreatic injuries in children:operate or observe[J].J Pediatr Surg, 2011, 46(6):1140-1143.
13. Oláh A, Issekutz A, Haulik L, et al.Pancreatic transection from blunt abdominal trauma:early versus delayed diagnosis and surg-ical management[J].Dig Surg, 2003, 20(5):408-414.
14. Krige JE, Thomson SR.Operative strategies in pancreatic trauma:keep it safe and simple[J].S Afr J Surg, 2011, 49(3):106-109.
15. Rogers SJ, Cello JP, Schecter WP.Endoscopic retrograde cholangiopancreatography in patients with pancreatic trauma[J].J Trauma, 2010, 68(3):538-544.
16. Fisher M, Brasel K.Evolving management of pancreatic injury[J].Curr Opin Crit Care, 2011, 17(6):613-617.

Previous Article
Progress in Minimally Invasive Surgery for Atrial Fibrillation

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Diagnosis and Treatment of Pancreatic Trauma

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Format

Content