胰头十二指肠切除治疗慢性胰腺炎

CLINICAL APPLICATION OF PANCREATICODUODENECTOMY IN CHRONIC PANCREATITIS

目的探讨胰头十二指肠切除术在胰头肿块型慢性胰腺炎诊治中可行性。方法回顾分析18例胰头肿块型慢性胰腺炎行胰头十二指肠切除术的临床资料。结果手术方式包括:Whipple法3例,Child法11例,保留十二指肠水平段胰头十二指肠切除术法4例;平均手术时间5.5±0.68h,平均出血量400±125ml;手术并发症:胆漏、胰漏2例,左膈下积液2例,肺部感染1例,其中死亡1例为胰漏伴感染出血,发生率占27.7%;平均住院日27.3±3d。结论肿块型慢性胰腺炎行胰头十二指肠切除术效果确切,是可行的,但有一定的风险。

Objective To investigate the feasibility of Pancreaticoduodenectomy in mass-forming type chronic pancreatitis located in the head of the pancreas. Methods The clinical data from 18 patients with the disease treated by the operation from Jan 1984 to Aug 2007 were analyzed retrospectively. Results Pancreatic resection included ： Whipple operation for 3 cases, Child operation for 11 cases and the part of the duodenum preservation pancreateetomy for 4 cases. Average operation time was 5.5 ± 0. 68 h, and average blood loss was 400 ± 125 ml. Operative morbidity was 27.7% （n =5）. One patient died. Mean hospital stay was 27.3 ±3 d. Conclusion Pancreaticoduodenectomy is a curative-intent treatment for the mass-forming type chronic pancreatitis located in the head of the pancreas but with certain risk.