老年人胰十二指肠切除术后早期并发症的防治

目的探讨老年患者行胰十二指肠切除术的可行性。方法回顾性分析我院1997年至2007年收治的152例60岁以上老年患者胰十二指肠切除术相关资料。结果152例高龄患者术后早期并发症发生48例（31.6%）,其中胰瘘9例,胆瘘8例,肠瘘1例,腹腔内出血2例,上消化道出血2例,腹腔感染积液3例,胆系感染2例,肺部感染3例,胸腔积液1例,切口感染8例,切口裂开1例,胃排空障碍2例,心功能不全2例,急性心肌梗死、严重贫血、脑出血、急性肾衰各1例。结论手术适应症的慎重掌握,手术专业组规范熟练的技术操作及围手术期认真管理是老年患者行胰十二指肠切除手术安全性的重要保证。

The Prevention and Cure of Early Complication for Pancreaticoduodenectomy in Elderly Patients

Objective To investigate the feasibility of pancreaticoduodenectomy in patients over 60 years.Methods The clinical data of 152 patients with age over 60 years receiving pancreaticoduodenectomy in our hospital from 1997 to 2007 were respectively analyzed.Results Postoperative complications occurred in 48 patients(31.6%). Pancreatic fistula 9 cases,biliary fistula 8 case,intestinal fistula 1 case,abdominal hemorrhage 2 cases,upper gastrointestinal hemorrhage 2 cases,abdominal cavity infection 3 cases,biliary infection 2 cases,pulmonary infection in 3 cases,hydrothorax 1 case,infection of incisional wound 8 cases,disruption of wound 1 case,gastric paralysis 2 cases,cardiac insufficiency 2 cases. Acute myocardial infarction,severity anemia,cerebral hemorrhage and acute renal failure one case respectively.Conclusions Pancreaticoduodenectomy adaptation should be cautiously attended in aged people.The excellent and standard operative technique of the operators and intensive perioperative care should be emphasized for senile patients,and these are important for operative security.