经窦道<b>Foley</b>导尿管治疗胰十二指肠切除术后复杂胰瘘伴静脉大出血1例报告

付裕; 王洋; 韩万斌; 周荣幸

doi:10.12449/JCH241123

经窦道Foley导尿管治疗胰十二指肠切除术后复杂胰瘘伴静脉大出血1例报告

DOI: 10.12449/JCH241123

付裕¹,
王洋²,
韩万斌²,
周荣幸^1, , ,

1.
四川大学华西医院胆道外科，成都 610041
2.
四川大学华西广安医院肝胆胰外科，四川广安 638550

基金项目:

四川省科技支撑项目 (2023YFS0183)

伦理学声明：本例报告已获得患者家属知情同意。

利益冲突声明：本文不存在任何利益冲突。

作者贡献声明：付裕负责课题设计，资料采集与分析，查阅文献，撰写论文；王洋、韩万斌参与收集数据，修改论文；周荣幸负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
周荣幸， rongxingzhou@126.com （ORCID： 0009-0008-0970-1491）

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出版历程
- 收稿日期: 2024-03-22
- 录用日期: 2024-04-11
- 出版日期: 2024-11-25

Clinical effect of Foley catheter through sinus tract in treatment of complex pancreatic fistula with massive venous hemorrhage after pancreaticoduodenectomy： A case report

Yu FU¹,
Yang WANG²,
Wanbin HAN²,
Rongxing ZHOU^{1
, ,
,}

1.
Department of Biliary Surgery，West China Hospital，Sichuan University，Chengdu 610041，China
2.
Department of Hepatobiliary and Pancreatic Surgery，West China Guangan Hospital，Sichuan University，Guangan，Sichuan 638550，China

Research funding:

Science and Technology Support Project of Sichuan Province (2023YFS0183)

More Information

Corresponding author: ZHOU Rongxing， rongxingzhou@126.com （ORCID： 0009-0008-0970-1491）

摘要

摘要: 目前，对于胰十二指肠切除术后胰瘘伴出血的治疗，血管介入和手术是主要的治疗手段，但以上治疗方法都存在一定的弊端，例如手术后出现再次胰瘘、出血、腹腔感染等并发症，介入治疗难以发现出血部位等。本文报道1例经引流管窦道置入Foley导尿管球囊压迫治疗胰十二指肠切除术后复杂性胰瘘伴静脉大出血患者。经导尿管球囊加压止血及有效引流，患者出血停止，消化道瘘痊愈，无胰腺假性囊肿、肠缺血、门静脉高压等并发症。
- 胰腺肿瘤 /
- 胰十二指肠切除术 /
- 导尿管插入术 /
- 胰腺瘘 /
- 手术后出血
Abstract: At present， vascular intervention and surgery are the main methods for the treatment of pancreatic fistula with bleeding after pancreaticoduodenectomy， but these treatment methods have certain drawbacks， such as the complications of pancreatic fistula， bleeding， and abdominal infection after surgical treatment， and interventional treatment sometimes fails to identify the bleeding site. This article reports a case of complex pancreatic fistula with massive venous hemorrhage after pancreaticoduodenectomy treated with Foley catheter balloon compression through the drainage tube sinus. Bleeding was arrested and gastrointestinal fistula was cured after catheter balloon compression and effective drainage， with no complications such as pancreatic pseudocyst， intestinal ischemia， and portal hypertension.
- Pancreatic Neoplasms /
- Pancreaticoduodenectomy /
- Urinary Catheterization /
- Pancreatic Fistula /
- Postoperative Hemorrhage

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图 1 患者术前MRI检查

注： a，T₂压脂像可见胰腺钩突囊实性占位（白色箭头）；b，T₁延迟期。

Figure 1. Preoperative MRI of patient

下载: 全尺寸图片幻灯片

图 2 患者止血后影像检查

注： a，CT平扫可见抽尽气囊后的Foley导尿管（白色箭头），体外引流的主胰引流管（黑色箭头）；b，胃瘫恢复后调整导尿管进入输入袢小肠，行造影并结合口服造影，可见造影剂均入胃后顺利进入输出袢小肠。

Figure 2. Imaging examination of patient after hemostasis

下载: 全尺寸图片幻灯片

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