摘要
Objective: To explore the way to lower the morbidity and mortality of patients after pancreaticoduodenec- tomy. Methods: Between March 1998 and March 2001, 26 patients with periampullary tumors received pancre- aticoduodenectomy (PD) with Roux-Y anastomosis to reconstruct the digestive tract. Of these patients, 6 had ductal cell carcinoma at the head of the pan- creas, 8 distal common bile duct carcinoma, 5 amp- ullar adenocarcinoma of the Vater, 6 duodenal ade- nocarcinoma, and 1 duodenal malignant lynphoma. A 30-40 cm free vascularized segment of the proxi- mal jejunum was taken and pulled up to the bed of the duodenum for end-to-end pancreaticojejunosto- my, end-to-side choledocojejunostomy or side-to-side jejunojejunostomy by a single loop. Results: The operative mortality was zero. Postoper- ative intraabdominal hemorrhage occurred in 2 pa- tients, but no leakage during pancreaticojejunostomy or choledocojejunostomy as well as abdominal infec- tion. The patients were discharged from the hospital on the tenth to fourteenth day after operation. Fol- low-up for 5 to 36 months (mean 21 months) re- vealed chronic steatorrhea and malnutrition in one patient (3.85%), and good digestive function and normal nutritional status in 25 (96.15%). No bile reflux gastritis, retrograde infection, anastomotic ul- cer, and dumping syndrome were observed. Conclusion: Our results show that this procedure can effectively reduce the morbidity and mortality of pa- tients after PD.
Objective: To explore the way to lower the morbidity and mortality of patients after pancreaticoduodenec- tomy. Methods: Between March 1998 and March 2001, 26 patients with periampullary tumors received pancre- aticoduodenectomy (PD) with Roux-Y anastomosis to reconstruct the digestive tract. Of these patients, 6 had ductal cell carcinoma at the head of the pan- creas, 8 distal common bile duct carcinoma, 5 amp- ullar adenocarcinoma of the Vater, 6 duodenal ade- nocarcinoma, and 1 duodenal malignant lynphoma. A 30-40 cm free vascularized segment of the proxi- mal jejunum was taken and pulled up to the bed of the duodenum for end-to-end pancreaticojejunosto- my, end-to-side choledocojejunostomy or side-to-side jejunojejunostomy by a single loop. Results: The operative mortality was zero. Postoper- ative intraabdominal hemorrhage occurred in 2 pa- tients, but no leakage during pancreaticojejunostomy or choledocojejunostomy as well as abdominal infec- tion. The patients were discharged from the hospital on the tenth to fourteenth day after operation. Fol- low-up for 5 to 36 months (mean 21 months) re- vealed chronic steatorrhea and malnutrition in one patient (3.85%), and good digestive function and normal nutritional status in 25 (96.15%). No bile reflux gastritis, retrograde infection, anastomotic ul- cer, and dumping syndrome were observed. Conclusion: Our results show that this procedure can effectively reduce the morbidity and mortality of pa- tients after PD.
