摘要
目的探讨改良Takada法保留十二指肠的胰头全切除术治疗胰头部病变的临床应用价值。方法总结分析2013年9月至2014年9月福建医科大学附属漳州市医院及漳州正兴医院实施改良Takada法保留十二指肠的胰头全切除术6例的临床资料。结果手术时间（281．7±42．6）min，术中出血量（300±187）ml，术后恢复进食时间（3．7±1．6）d，术后住院时间（9±4．3）d。6例均保留十二指肠乳头及vater壶腹，一期胰管端端吻合原位重建。术后发生并发症2例，胰瘘1例，胆漏1例，经非手术治疗痊愈。无围手术期死亡病例。术后病理为慢性胰腺炎3例，胰腺原发肿瘤3例。术后随访6～17个月，中位随访时间13个月，均无复发。结论改良Takada法保留十二指肠胰头全切除术能清除胰头的病变组织，创伤小，手术安全性高。胰管．胰管端端吻合原位重建，更符合生理。
Objective To explore the clinical application value of duodenum-preserving total pancreatic head resection by modified Takada procedure in the treatment of pancreatic head lesions. Methods The clinical data of 6 cases of modified Takada duodenum-preserving total pancreatic head resection in Zhangzhou Affilicated Hospital of Fujian Medical University and Zhangzhou Zhengxing Hospital from Sep 2013 to Sep 2014 was retrospectively analyzed. Results The mean operative time was （281.7 ~42. 6） minutes,the mean intraoperative blood loss was （300±187） ml. The mean time to recovery to oral food-intake was （ 3.7±1.6） days. Average length of hospital stay after operation was （ 9 ±4. 3 ） days. Of these cases, all preserved duodenal papilla and Vater ampulla and one-stage end-to-end anastomosis of the pancreatic duct in situ was done. Postoperative complications developed in 2 cases, one was pancreatic leakage and other one was bile leakage, all were cured conservatively. No perioperative deaths occurred. Postoperative pathology proved chronic pancreatitis in 3 cases and primary pancreatic tumors in another. 3 Follow-up time ranged from 6 to 17 months, median was 13 months. There was no case of recurrence. Conclusions The modified Takada duodenum-preserving total pancreatic head resection removes pancreatic head where the lesion lies totally. One-stage end-to-end pancreatic duct reconstruction in situ is safe, ensuring fast and uneventful recovery.
出处
《中华普通外科杂志》
CSCD
北大核心
2016年第5期382-386,共5页
Chinese Journal of General Surgery
