探讨胰腺外伤的个体化处理措施。

回顾性分析我院近10年来收治的40例胰腺外伤患者的资料。

40例患者中12例行保守治疗，28例行手术治疗。其中行单纯手术引流6例，清创修补引流术11例，B超引导经皮穿刺置管引流3例，行胰尾或胰体尾切除术4例，右半肝+远端胰腺+脾切除1例，远端胰腺胃吻合+空肠造瘘1例，胰十二指肠切除1例，肝、胆总管、十二指肠、胰修补+胃及空肠造瘘1例。治愈38例，死亡2例，发生胰瘘4例，十二指肠漏1例。

根据胰腺外伤的位置和程度，选择个体化的治疗方法是提高胰腺外伤治愈率的关键。B超引导下穿刺置管引流及胰胃吻合等方法提供了一种新的治疗思路。

To discuss the individual management for the injuries of pancreas.

Forty patients with injuries of pancreas treated during the last 10 years in our hospital, were analyzed retrospectively for the surgical treatment and their clinical results.

Twelve cases were treated by conservative treatment, and 28 cases were treated by operation. Simple closed suction drainage near the pancreatic bed was performed in 6 patients. Debridement, suture and closed suction drainage were performed in 11 patients. Ultrasound guided percutaneous catheter drainage was performed in 3 patients. Distal pancreatectomy was performed in 4 patients. Resection of the right side of the liver, the distal pancreas and the spleen was performed in 1 patient. Pancreaticogastrostomy and jejunum stoma were performed in 1 patient. Pancreatoduodenectomy was performed in 1 patient. Repair of the liver, the common bile duct, the duodenum, and the pancreas, combined with jejunum stoma and gastrostomy were performed in 1 patient. Thirty-eight patients were cured, and 2 patients died. Pancreatic fistula occurred in 4 cases.

The principle of individualization is the key to improve the effect of treatment according to the characteristics of trauma. Ultrasound guided percutaneous catheter drainage and pancreaticogastrostomy provide a new way for the injuries of pancreas.