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表 1 胰腺术后胰瘘的分级依据和治疗措施
级别 引流液淀粉酶浓度≥血清淀粉酶浓度上限3倍 持续性胰周引流≥3周 胰瘘相关临床决策改变* 积液需经皮穿刺或内镜针对性干预 胰瘘相关性出血行血管造影 二次手术 生化漏(非胰瘘) 是 否 否 否 否 否 B级 是 是 是 是 是 否 C级 是 是 是 是 是 是 *延长住院时间或ICU入住时间，包括针对胰瘘或胰瘘导致后果的药物使用(生长抑素及其类似物、肠内肠外营养、输血或其他药物) 
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表 2 不同胰瘘预后因素的评分
预后因素 参数 赋值(分) 胰腺质地 硬 0 软 2 病理 胰腺癌或慢性胰腺炎 0 除胰腺癌或慢性胰腺炎外的其他胰腺疾病 1 胰管直径(mm) ≥5 0 4 1 3 2 2 3 ≤1 4 术中失血量(ml) ≤400 0 ＞400~700 1 ＞700~1000 2 ＞1000 3
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表 3 胰腺术后出血分级的原则
分级 严重程度 临床表现 诊断策略 治疗 A 轻度 腹腔或消化道出血，无血红蛋白浓度改变，无相关的临床表现 血常规、超声或CT等 无需特殊针对性治疗 B 中度 腹腔或消化道出血，出现血容量下降相关的临床表现，血红蛋白浓度＜30 g/L，未达到休克状态 血常规、超声、血管造影、CT及内镜等 需要血管介入、内镜或再次手术等针对性治疗，输血量≤3个单位红细胞 C 重度 腹腔或消化道出血，血红蛋白浓度＞30 g/L，表现为低血容量性休克 血常规、超声、血管造影、CT及内镜等 需要血管介入、内镜或再次手术等针对性治疗，输血量＞3个单位红细胞
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表 4 术后胃排空延迟的分级标准
分级 临床表现 A 术后置胃管4~7 d，或术后3 d拔管后需再次置管；术后7 d不能进食固体食物，可伴呕吐，可能需应用促胃肠动力药物 B 术后置胃管8~14 d，或术后7 d拔管后需再次置管，术后14 d不能进食固体食物，伴呕吐，需应用促胃肠动力药物 C 术后置胃管＞14 d，或术后7 d拔管后需再次置管，术后21 d不能进食固体食物，伴呕吐，需应用促胃肠动力药物
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表 5 Clavien Dindo分级系统内容
分级 定义 Ⅰ 任何偏离术后正常恢复过程，但不需要药物治疗、手术干预、内镜或介入治疗的情况；仅包括使用止吐药、退热药、镇痛药、利尿药、补液和理疗可以解决的情况；本级亦包括可以在床旁处理的感染伤口 Ⅱ 需要除Ⅰ级中列出的药物以外的药物治疗的并发症，亦包括输血和全肠外营养 Ⅲ 需要手术干预、内镜或介入治疗的并发症 Ⅲa 不需要全身麻醉 Ⅲb 需要全身麻醉 Ⅳ 危及生命的并发症(包括中枢神经系统并发症)*；需要在重症监护室处理 Ⅳa 单器官功能衰竭(包括需要透析) Ⅳb 多器官功能衰竭 Ⅴ 死亡 包括脑出血、脑梗死、蛛网膜下腔出血，不包含短暂性脑出血；如果患者出院时有并发症，则在并发症的分级后加后缀“d”，此标记表明需要对患者进行随访后充分评估该并发症
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