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中华普通外科学文献(电子版) ›› 2026, Vol. 20 ›› Issue (04) : 269 -271. doi: 10.3877/cma.j.issn.1674-0793.2026.04.009

病例报告

胰十二指肠切除术后胰管支架所致穿孔及出血一例
曹喆, 张锰钢, 翁桂湖, 田锋, 张太平()   
  1. 100730 北京,中国医学科学院北京协和医学院 北京协和医院基本外科
  • 收稿日期:2026-02-27 出版日期:2026-08-01
  • 通信作者: 张太平
  • 基金资助:
    国家重点研发计划资助项目(2023YFC2413400); 协和人才培育支持计划D类项目(UHB11961); 中央高水平医院临床科研业务费项目(2025-PUMCH-A-070)

Postoperative pancreatic stent fistula and hemorrhage following pancreaticoduodenectomy: A case report

Zhe Cao, Menggang Zhang, Guihu Weng   

  • Received:2026-02-27 Published:2026-08-01
引用本文:

曹喆, 张锰钢, 翁桂湖, 田锋, 张太平. 胰十二指肠切除术后胰管支架所致穿孔及出血一例[J/OL]. 中华普通外科学文献(电子版), 2026, 20(04): 269-271.

Zhe Cao, Menggang Zhang, Guihu Weng. Postoperative pancreatic stent fistula and hemorrhage following pancreaticoduodenectomy: A case report[J/OL]. Chinese Archives of General Surgery(Electronic Edition), 2026, 20(04): 269-271.

图1 置架患者术前增强CT影像 胰头34 mm×30 mm囊实性病变,延迟强化,恶性不除外(黄色箭头);上游胰管(绿色箭头)及肝内外胆管(红色箭头)扩张。A. 动脉期;B. 门静脉期;C~D. 矢状位
图2 置架患者术后凝血功能指标变化情况 A. 活化部分凝血活酶时间;B. 国际标准化比值;C. 纤维蛋白原水平;D. 凝血酶原时间
图3 全身麻醉下患者胃镜经口插入止血时的发现 在全身麻醉下,患者取左侧卧位,胃镜经口插入,可见胃底大量暗红色血块,胃底黏膜光滑,未见活动性出血。胃肠吻合口可见直径约1 cm黄白色溃疡,无活动性出血。进入输入袢,见条状血凝块向上游延伸,至胆肠吻合口附近。A. 胰管支架远端压迫并穿破肠壁;B. 钛夹夹闭出血点
图4 术后复查腹部增强CT显像 A. 术后3个月时动脉期;B. 术后3个月时门静脉期;C. 术后15个月时动脉期;D. 术后15个月时门静脉期
[1]
乔海泉. Whipple手术胰瘘的探索与思考[J/OL]. 中华普通外科学文献(电子版), 2015, 9(3): 179–181.
[2]
Kadowaki S, Miura F, Amano H, et al. Where abouts of an internal short stent placed across the pancreaticojejunostomy following pancreatoduodenectomy[J]. J Hepato Biliary Pancreat, 2012, 19(5): 566–577.
[3]
Guo C, Xie B, Guo D. Does pancreatic duct stent placement lead to decreased postoperative pancreatic fistula rates after pancreaticoduodenectomy? A meta-analysis[J]. Int J Surg, 2022, 103: 106707.
[4]
Huscher C, Perri G, Lazzarin G, et al. Coronary artery stent for securing high-risk pancreatico-jejunal anastomosis after pancreatoduodenectomy: A pilot series[J]. Ann Surg, 2022, 275(4): e665–e668.
[5]
Sun Y, Li Y, Liu Z, et al. Stent placement for the prevention of clinically-relevant postoperative pancreatic fistula following pancreaticojejunostomy: A systematic review and meta-analysis[J]. Am J Surg, 2024, 234: 122–128.
[6]
Jiang Y, Chen Q, Wang Z, et al. The prognostic value of external vs internal pancreatic duct stents in CR-POPF after pancreaticoduodenectomy: A systematic review and meta-analysis[J]. J Investig Surg, 2021, 34(7): 738–746.
[7]
Leng B, Shen C, Gao T, et al. Incidence, characteristics and risk factors of hypofibrinogenemia associated with tigecycline: A multicenter retrospective study in China[J]. Front Pharmacol, 2022, 13: 943674.
[8]
Firat O, Kara E, Malkan ÜY, et al. Tigecycline-associated hypofibrinogenemia: A single center, retrospective, controlled study[J]. Thromb Res, 2024, 236: 155–160.
[9]
Mintziras I, Maurer E, Kanngiesser V, et al. C-reactive protein and drain amylase accurately predict clinically relevant pancreatic fistula after partial pancreaticoduodenectomy[J]. Int J Surg, 2020, 76: 53–58.
[10]
Vilhav C, Fagman JB, Holmberg E, et al. C-reactive protein identifies patients at risk of postpancreatectomy hemorrhage[J]. Langenbecks Arch Surg, 2022, 407(5): 1949–1959.
[11]
Funamizu N, Utsunomiya T, Honjo M, et al. Preoperative C-reactive protein-to-albumin ratio predicts postoperative pancreatic fistula following pancreatoduodenectomy: A single-center, retrospective study[J]. Curr Oncol, 2022, 29(12): 9867–9874.
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