摘要
目的:探讨胰腺中段切除术(MP)治疗良性和低度恶性胰腺颈体部肿瘤的疗效。方法:回顾性分析2005年8月—2013年2月收治的32例胰腺颈体部良性和低度恶性肿瘤行MP患者资料(MP组),并与同期因良性和低度恶性胰腺肿瘤行胰十二指肠切除术(PD)的30例(PD组)和行胰体尾切除术(DP)的36例(DP组)患者资料进行比较。结果:MP组、PD组、DP组平均手术时间分别为(180.8±56.4)、(279.6±79.2)、(190.4±62.3)min;平均术中出血量分别为(196.5±185.7)、(482.6±288.5)、(320.7±240.3)mL;胃肠道功能恢复时间分别为(3.6±1.6)、(5.2±2.3)、(4.1±1.9)d;新增糖尿病例数分别为1、5、9例;术后需要补充胰酶例数分别为0、8、5例,以上指标3组间差异均有统计学意义(均P<0.05)。MP组、PD组、DP组术后胰瘘发生率(18.8%、12.5%、25.0%)以及其他围手术期指标差异均无统计学意义(均P>0.05)。平均随访38个月,各组均无肿瘤复发。结论:MP治疗良性或低度恶性胰腺颈体部肿瘤是一项合理的技术,能更好地保护胰腺外分泌和内分泌功能。
Objective： To investigate the clinical efficacy of middle pancreatectomy （MP） for benign or low-grade malignant tumors of the pancreatic neck and body. Methods： The clinical data of 32 patients undergoing MP for benign or low-grade malignant tumor of the pancreatic neck body （MP group） from August 2005 to February 2013 were retrospectively analyzed, and were also compared with the data of 30 patients undergoing pancreaticoduodenectomy （PD group） and 36 patients undergoing distal pancreatectomy （DP group） for benign or low-grade malignant pancreatic tumor during the same time period.Results： In MP, PD and DP group, the average operative time was （180.8＋56.4）, （279.6＋79.2） and （190.4＋62.3） min, average intraoperative blood loss was （196.5＋185.7）, （482.6＋288.5） and （320.7＋240.3） mL, time to bowel function recovery was （3.6＋ 1.6）, （5.2＋2.3） and （4.1＋ 1.9） d, number of newly developed diabetetic cases was 1, 5 and 9, and number of cases with postoperative pancreatic enzyme requirement was 0, 8 and 5, respectively. The differences in all above parameters among the three groups had statistical significance （all P〈0.05）. The incidence of postoperative pancreatic fistula in ME PD and DP group was 18.8%, 12.5% and 25.0% respectivel）5 which along with other perioperative variables among the three groups showed no statistical difference （all P〉0.05）. During the average follow-up period of 38 months, no tumor recurrence was noted in any of the groups. Conclusion： MP is a proper procedure for benign or low-grade malignant tumors in the neck and body of the pancreas, which allows better preservation of both exocrine and endocrine functions of the pancreas.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2014年第3期278-282,共5页
China Journal of General Surgery
关键词
胰腺切除术
胰腺肿瘤
胰腺瘘
手术后并发症
Pancreatectomy
Pancreatic Neoplasms
Pancreatic Fistula
Postoperative Complications
