关键词: 胰十二指肠切除术后迟发出血, 胰瘘, 介入治疗, 急诊手术

Abstract: Objective To observe and analyze the related factors of delayed hemorrhage after pancreaticoduodenectomy and to explore the management strategy of delayed hemorrhage.
Methods Reviewing 276 patients who underwent pancreaticoduodenectomy in Fujian Provincial Hospital from January 2015 to January 2020,univariate and multivariate analyses were performed on delayed hemorrhage related factors and treatment strategies were discussed.
Results The incidence of delayed hemorrhageis 9.1%(25/276),Among them,there were differences in age,pancreatic duct diameter,pancreatic fistula,bile leakage,and abdominal infection between the delayed hemorrhage group and the non-hemorrhage group(P<0.05）.While age ≥60,pancreatic duct diameter ≥3mm,pancreatic fistula and biliary leakage are independent factors of delayed hemorrhage.Pancreatic duct diameter ≥3mm is a protective factor,and the remaining three are risk factors.
Conclusion The cause of delayed hemorrhage is complicated and the mortality is high.It requires an experienced pancreatic treatment center and multidisciplinary combined treatment.Timely and appropriate treatment of hemorrhage and rehemorrhage is the key to reducing mortality.

Key words: delayedhemorrhagepost-pancreatoduodenectomy, pancreatic fistula, interventional treatment, emergency surgery