摘要
目的探讨胰十二指肠切除术在慢性胰腺炎治疗中的应用价值及疗效。方法回顾性分析第二军医大学附属长海医院1992年3月—2007年7月行胰十二指肠切除术(PD)治疗且术后证实为慢性胰腺炎的106例患者的临床资料,男87例,女19例,平均年龄为(51.2士1 2.2)岁。73例(68.9%)患者获得随访,平均随访时间为(41.3±29.6)个月。分析本组慢性胰腺炎患者施行PD的适应证及手术的近、远期疗效。结果 PD的手术适应证主要为肿块型慢性胰腺炎,不能除外肿瘤、经内科治疗不能缓解的顽固性腹痛,合并胆道或十二指肠梗阻及内镜介入治疗失败等。本组无1例患者因手术死亡,术后并发症发生率为15.1%(16/106)。术后新发糖尿病7例,脂肪泻5例,死亡7例(其中3例死于慢性胰腺炎并发症,2例死于胰腺癌,2例死于心肺疾病)。结论在严格控制手术适应证的前提下,PD治疗胰头部慢性胰腺炎的手术疗效较好,对提高患者的生活质量和控制疾病进程具有一定的临床应用价值。
Objective To discuss the indications for pancreatoduodenectomy（PD） in treatment of chronic pancreatitis and to evaluate its outcomes.Methods The clinical data of 106 patients with chronic pancreatitis（87 males,19 females,median age,[51.2±12.2]years）,who underwent PD during Mar.1992 to Jul.2007,were retrospectively analyzed.Seventy-three（68.9%） patients were followed up for a mean of（41.3±29.6） months. The indications and the perioperative and long-term outcomes of the patients were analyzed.Results All the 106 patients received PD,and their diagnoses were pathologically confirmed.The main indications for PD were intractable abdominal pain,common bile duct or duodenum obstruction,and tumor-like mass in the pancreatic head,with the possibility of pancreatic cancer.There were no operative deathes.The Postoperative complication rate was 15.1%.Seven patients developed diabetes mellitus and 5 had fat diarrhea after operation.Seven patients died during follow-up,including 3 due to complications of chronic pancreatitis,2 due to pancreatic cancer, and 2 due to cardiopulmonary disease.Conclusions PD is a safe and effective method for treatment of chronic pancreatitis of the pancreatic head,and it shows a clinical value in improving the life quality and disease control.
出处
《上海医学》
CAS
CSCD
北大核心
2010年第11期1003-1005,共3页
Shanghai Medical Journal
关键词
慢性胰腺炎
外科
胰十二指肠切除术
疗效
Chronic pancreatitis
Surgery
Pancreatoduodenectomy
Effectiveness
