中国实用外科杂志2025，Vol.45Issue(3)：356-360,5.DOI:10.19538/j.cjps.issn1005-2208.2025.03.22
十二指肠残端瘘预防及诊治进展
Progress in the prevention,diagnosis and treatment of duodenal stump fistula
摘要
Abstract
Duodenal stump fistula is a common and severe complication following gastrectomy,particularly prevalent after Billroth-Ⅱ and Roux-en-Y reconstruction.Clinical manifestations include epigastric pain,fever,and tachycardia,with severe cases progressing to life-threatening complications such as peritonitis,intra-abdominal infection,and shock.Diagnosis relies on imaging modalities,including CT and ultrasonography.Risk factors encompass age,sex,malnutrition,hypoalbuminemia,cirrhosis,as well as tumor location in gastric cancer.Notably,tumors involving the gastric antrum and pylorus are more prone to inducing stump fistula.Timely diagnosis and appropriate intervention are crucial for duodenal stump fistula.Mild cases may be managed solely with conservative treatment,such as fasting,gastrointestinal decompression,antibiotics,and nutritional support,while severe cases require surgical intervention.Endoscopic approaches are particularly beneficial for small,non-infected fistulas,offering a minimally invasive alternative to surgery,whereas open surgical intervention is reserved for advanced cases.Although the incidence of duodenal stump fistula is relatively low,improper management can lead to catastrophic outcomes.Therefore,tailored treatment plans based on individual patient profiles are essential to optimize therapeutic efficacy and improve prognosis.关键词
十二指肠残端瘘/胃手术/危险因素/诊治Key words
duodenal stump fistula/gastric surgery/risk factors/diagnosis and treatment分类
医药卫生引用本文复制引用
郑煌,Joshua Lin,邵岩飞,周雪亮,郑民华,孙晶..十二指肠残端瘘预防及诊治进展[J].中国实用外科杂志,2025,45(3):356-360,5.基金项目
National Natural Science Foundation of China(No.82473031,No.82273344) 国家自然科学基金项目(No.82473031,No.82273344) （No.82473031,No.82273344）
