保留十二指肠的胰头勺式切除术

Scoop-type Duodenum-preserving Pancreatic Head Resection

目的探讨保留十二指肠的胰头勺式切除术的手术安全性及临床经验总结。方法8例慢性胰腺炎、胰管结石TypeⅠ或Ⅲ型患者,行保留十二指肠的胰头勺式切除术,术中将胰头组织剔除成勺状,切取桥袢空肠与胰勺吻合、完成胰勺空肠Roux-en-Y术。结果8例手术均获成功,无手术死亡、无胰瘘发生、无十二指肠血运障碍。经2个月-19年随访,胰腺炎症状消失,空腹血糖基本正常,生活质量好。结论正确有效的围手术期及术中处理使保留十二指肠的胰头勺式切除术安全、有效、可行。

Objective To investigate the surgical safety and clinical experiences of the scoop-type duodenum-preserving pancreatic head resection.Methods Specific surgical techniques and complications were retrospectively analyzed in 8 cases of scoop-type duodenum-preserving pancreatic head resection for chronic pancreatitis and Type Ⅰ or Ⅲ pancreatic duct calculi.The main procedure of the operation was to resect the pancreatic head into scoop-like shape for anastomosis with a 35cm jejunum loop,and then to complete the Roux-en-Y pancreatic scoop-jejunum anstomosis.Results 8 cases were successfully operated without operative mortality or pancreatic fistula,no ishemia of the duodenum blood supply was observed.During the 2 months to 19 years follow-up,all the cases were free of pancreatitis symptom with normal fasting blood glucose and better life quality.Conclusion With effective perioperative and intraoperative management,scoop-type duodenum-preserving pancreatic head resection is safe,effective and feasible.