Prevention and treatment of the hemorrhage after pancreaticoduodenectomy
10.3760/cma.j.issn.1673-9752.2018.07.009
- VernacularTitle:胰十二指肠切除术后出血的预防及处理
- Author:
Baiyong SHEN
1
;
Yajin CHEN
;
Bing PENG
;
Guang TAN
;
Yu JIANG
;
Jun CAO
;
Yunqiang CAI
Author Information
1. 200025,上海交通大学医学院附属瑞金医院胰腺中心上海交通大学医学院胰腺疾病研究中心
- Keywords:
Pancreatic neoplasms;
Pancreaticoduodenectomy;
Laparoscopy;
Digestive tract reconstruction;
Complications;
Hemorrhage;
Prevention
- From:
Chinese Journal of Digestive Surgery
2018;17(7):682-686
- CountryChina
- Language:Chinese
-
Abstract:
Pancreaticoduodenectomy (PD) is a standard surgical method for periampullary cancer.The hemorrhage is a dangerous complication after PD,how to effectively prevent and treat hemorrhage is a difficult point of pancreatic surgery,and also a key for reducing postoperative mortality.Four famous experts and their teams in surgical fiell explored prevention and treatment of the hemorrhage after PD from different angles based on clinical experiences.Professor Shen Boyong has conducted a discussion on early and Date hemorrhage after PD combined with previous successful experiences and prospective research data.Professor Chen Yajin suggested preventing hemorrhage in the aspects of anatomical resection,anastomosis and reconstruction,peritoneal drainage-tube placement and postoperative management based on different causes of hemorrhage.Professor Peng Bing paid attention to hemorrhage after laparoscopic PD,and supposed that intraoperative careful hemostasis,precise anastomosis,reasonable peritoneal drainage-tube placement and optimal perioperative management can reduce incidences of postoperative pancreatic fistula,biliary fistula and intra-abdominal infection,thereby lowering the incidence of hemorrhage.Professor Tan Guang respectively proposed processing strategies of hemorrhagc for grading A (mild at early stage),B (severe at early stage and mild at late stage) and C (severe at late stage).
