Diagnosis and treatment of postoperative gastroduodenal fistulas in patients with severe acute pancreatitis
- VernacularTitle:重症急性胰腺炎术后并发胃十二指肠瘘的诊治
- Author:
Bei SUN
;
Ji LIU
;
Hongchi JIANG
;
Jun LI
;
Qinghui MENG
;
Jie LIU
;
Linfeng WU
;
Xiangsong WU
;
Panquan LI
- Publication Type:Journal Article
- Keywords:
Pancreatitis,acute necrotizing;
Postoperative complications;
Gastrodduodenal fistula
- From:
Chinese Journal of Pancreatology
2008;8(5):322-323
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the etiologies, mechanisms, diagnosis and management of postoperative gastroduodenal fistulas in patients with severe acute pancreatitis (SAP). Methods The clinical data of 18 cases of postoperative gastroduodenal fistulas (PGF) in patients with SAP admitted in our hospital from Jan, 1996 to Dec, 2007 were analyzed retrospectively. Results Of 18 patients with SAP, 4 patients underwent cholecystectomy and common bile duct exploration, 4 patients underwent pancreatic debridement and open saucer-type drainage, 10 patients underwent pancreatic debridement and pancreas-bed mobilization, abdominal closed drainage. Duodenal fistula occurred in 12 patients (66.7%), gastric fistula occurred in 6 patients (33.3%). 14 patients (77.8%) developed gastroduodenal fistula within 3 weeks of surgery, and 4 patients developed gastroduodenal fistula after 3 weeks of surgery. 16 patients (88.9%) were cured with non-surgical management including drainage, antibiotics and abscess cavity douching. The average length of stay was 65 days. Two patients (11.1%) died of intra-abdominal hemorrhage and intra-abdominal infection complicated with abdominal compartment syndrome and multiple organ dysfunction syndromes, respectively. Conclusions SAP complicated with postoperative gaatroduodenal fistulas could be cured by appropriate non-surgical treatment.
