摘要
目的探讨慢性钙化性胰腺炎的分型与手术治疗。方法采用回顾性描述性研究方法。收集2015年1月至2019年12月湖南省人民医院收治的121例慢性钙化性胰腺炎患者的临床资料;男99例,女22例;中位年龄为43岁,年龄范围为10~78岁。Ⅰ型慢性钙化性胰腺炎选择行胰十二指肠切除术、保留十二指肠胰头全切除术、保留十二指肠胰头勺式切除术,合并胰周假性囊肿行假性囊肿外引流术。Ⅱ型慢性钙化性胰腺炎选择行胰体尾+脾切除术、胰管切开取石+胰管空肠Roux-en-Y吻合术。Ⅲ型慢性钙化性胰腺炎选择行胰十二指肠切除术、保留十二指肠胰头勺式切除术,合并胰周假性囊肿行假性囊肿外引流术。Ⅳ型慢性钙化性胰腺炎行胰管盆式内引流术。观察指标:(1)手术情况。(2)术后情况。(3)随访情况。采用门诊和电话方式进行随访,了解患者术后疼痛复发或再发胰腺炎、血糖情况、新发糖尿病及腹泻。随访时间截至2020年1月。正态分布的计量资料以±s表示;偏态分布的计量资料以M(范围)表示。计数资料以绝对数表示。结果(1)手术情况:48例Ⅰ型慢性钙化性胰腺炎患者中,15例行胰十二指肠切除术,手术时间为(6.8±1.9)h,术中出血量为(398±110)mL;8例因胰管不扩张行保留十二指肠胰头全切除术,手术时间为(3.7±0.8)h,术中出血量为(137±62)mL;25例胰管扩张均行保留十二指肠胰头勺式切除术,手术时间为(3.9±1.5)h,术中出血量为(123±58)mL。8例Ⅱ型慢性钙化性胰腺炎患者中,2例行胰体尾+脾切除术,平均手术时间为5.1 h,平均术中出血量为200 mL;6例行胰管切开取石+胰管空肠Roux-en-Y吻合术,手术时间为(2.7±0.8)h,术中出血量为(145±39)mL。49例Ⅲ型慢性钙化性胰腺炎患者,4例行胰十二指肠切除术,手术时间为(7.2±1.4)h,术中出血量为(415±98)mL;45例因胰管扩张行保留十二指肠胰头勺式切除术,手术时间为(4.3±1.1)h,术�
Objective To investigate the classification and surgical management of chronic calcifying pancreatitis.Methods The retrospective and descriptive study was conducted.The clinical data of 121 patients with chronic calcifying pancreatitis who were admitted to Hunan Provincial People′s Hospital from January 2015 to December 2019 were collected.There were 99 males and 22 females,aged from 10 to 78 years,with a median age of 43 years.The patients with typeⅠchronic calcifying pancreatitis underwent pancreaticoduodenectomy,duodenum-preserving pancreatic head total resection,or duodenum-preserving pancreatic head spoon-type resection respectively,and external drainage when combined with peripancreatic pseudocyst.Patients with typeⅡchronic calcifying pancreatitis underwent resection of pancreatic body and tail combined with splenectomy or dissection of pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis.Patients with typeⅢchronic calcifying pancreatitis underwent pancreaticoduodenectomy or duodenum-preserving pancreatic head spoon-type resection,and external drainage when combined with peripancreatic pseudocyst.Patients with typeⅣchronic calcifying pancreatitis underwent basin-type internal drainage.Observation indicators:(1)surgical situations;(2)postoperative situations;(3)follow-up.Follow-up using outpatient examination and telephone interview was performed to detect the recurrence of pain or chronic pancreatitis,the data of blood glucose,the morbidity of diabetes and diarrhea after surgery up to January 2020.Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were described as M(range).Count data were represented as absolute numbers.Results(1)Surgical situations:of the 48 patients with typeⅠchronic calcifying pancreatitis,15 patients underwent pancreaticoduodenectomy with the operation time of(6.8±1.9)hours and volume of intraoperative blood loss of(398±110)mL,8 patients underwent duodenum-preserving pancreatic head total r
作者
陈梅福
姚佳水
唐泽涛
成伟
朱朝庚
李国光
蔡翊
谢阳云
Chen Meifu;Yao Jiashui;Tang Zetao;Cheng Wei;Zhu Chaogeng;Li Guoguang;Cai Yi;Xie Yangyun(Department of Pancreatic and Splenic Surgery of Hepatobiliary Hospital,Hunan Provincial People′s Hospital,the First Affiliated Hospital of Hunan Normal University,Translational Medicine Laboratory of Pancreas Disease of Hunan Normal University,Changsha 410005,China)
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2020年第4期394-400,共7页
Chinese Journal of Digestive Surgery
基金
湖南省科学技术厅科技计划项目(2011FJ3210)
长沙市科技计划项目(K1106038-31)。
关键词
胰腺炎
慢性
胰管结石
分型
外科手术
疗效
Pancreatitis
chronic
Pancreatic duct stones
Classification
Surgical procedures
operative
Efficacy
