乳糜瘘是胰腺手术术后的并发症之一,主要根据患者术后引流液性质(术后≥3大,甘油三酯浓度≥1.2 mmol/L)进行诊断.发生机制包括淋巴管堵塞、损伤及渗出.高危因素涉及临床病理、手术过程及术后管理三个方面.大部分乳糜瘘可通过保守治疗(调整营养及生长抑素类药物)治愈,严重的乳糜瘘需要介入操作及手术治疗.本文主要对胰腺手术后乳糜瘘的发生机制及诊疗措施进行综述.%Chylous fistula is a postoperative complication following pancreatic surgery,it is mainly diagnosed according to the nature of the patient's drainage fluid (≥3 days after surgery,triglyceride concentration ≥ 1.2 mmol/L).The mechanism of occurrence includes obstruction,injury and exudation of the lymph-vessels.Risk factors can be concluded into 3 aspects:clinicopathological features,surgical procedure and postoperative management.Most of the chylorrhea can be cured by conservative treatment like modified dietary measures and somatostatin,while severe cases still requires intervention and surgical treatment.This article reviewed the risk factors and treatment approaches of postoperative chylous fistula,and elucidated relative mechanisms,hoping to provide guidance in clinical prevention,diagnosis and treatment of chylous fistula.
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