胰管结石外科手术治疗18例分析

Surgical treatment for pancreatic duct calculi:a report of 18 cases

目的探讨胰管结石的手术治疗方式。方法对南昌大学第二附属医院肝胆外科2002-2007年手术治疗的18例胰管结石进行回顾性分析。结果11例行胰管切开取石、胰管空肠Roux-en-Y吻合术,5例行胰十二指肠切除术,1例行保留十二指肠的胰头次全切除加头、尾侧胰腺断端空肠吻合术,1例行胰体尾切除加脾切除术。无手术死亡,无胰瘘、胆瘘病例发生。术后腹痛、腹泻等症状均明显缓解。随访时间1个月至5年,除1例伴胰腺癌病人于术后28个月死亡外,其余病人均健在。结论外科手术是治疗胰管结石的有效方法,应遵循个体化的原则选择手术方式。

Objective To explore the method of surgical treatment for pancreatic duct calculi. Methods The clinical data of 18 cases of pancreatic duct calculi performed surgery from 2002 to 2007 in the Department of Hepatobiliary Surgery of the Second Affiliated Hospital of Nanchang University were analyzed retrospectively. Results Eleven cases were performed with lateral pancreaticojejunostomy. Five cases were performed pancreaticoduodenectomy. One case was performed with duodenum-preserving pancreatie head resection. One case was performed with distal pancreatectomy and splenectomy. All the cases were cured successfully. No pancreatic or bile fistula was occurred, hnprovement of clinical symptoms ai）er surgery was achieved in all cases. All the cases were followed up from 1 month to 5 years. Except one case died of pancreatic carcinoma twenty-eight months after the operation, all other cases were survived. Conclusion Surgical intervention is recommended for pancreatic duct calculi cases. The principle of individualized therapy should be followed.