膵頭十二指腸切除術後の合併症
特に膵液瘻について
1989 年 39 巻 4 号 p. 523-528
詳細
1989 年 39 巻 4 号 p. 523-528
The cause, treatment and prophylactic measures of postoperative pancreatic fistula were examined in 45 patients who underwent pancreaticoduodenectomy. The incidence of pancreatic fistula was 24.4% (6/11) and 14.7% (5/14) respectively, in patients with and without jaundice just prior to the operation, being significantly lower in the latter group. The correlation of fistula with duct diameter in the remaining pancreas, was 31.5% (6 out 19 cases) in patients with less than 2 mm ductal diameter. The incidence of fistula was decreased when the duct diameter was larger and no occurrence was recognized in 5 cases with ductal diameter of more than 6.1mm. As a pancreatic fistula is intractable, tube insertion into the pancreatic duct should be made firmly during operation to prevent its occurrence.
