保留胰腺功能的局部切除治疗胰头部良性肿瘤(附11例报告)

Local resection of benign tumors in head of pancreas to reserve pancreatic function

目的 探讨对胰头部较大的良性肿瘤采用局部切除的可行性及手术方法。方法 通过对一组１１ 例胰头部良性占位性病变病例治疗的回顾性分析，说明局部切除术治疗该病例的优点及术中应注意的问题。结果 （１）该术式是可行的，与以往通常采用的Ｗｈｉｐｐｌｅ 手术相比，该术式操作简单对机体的侵袭性小，术后并发症发生率低，恢复快，消化功能保持良好；（２）对肿瘤与胆管关系密切者，先行胆管切开探查放置指引管可防止误伤胆管；（３） 采用胰腺创面与空肠行侧侧吻合术可有助于降低术后胰漏的发生。结论 该方法可作为治疗胰头部良性肿瘤的首选术式。

Objective To assess the feasibility of local resection of benign tumors in the head of pancreas to reserve pancreatic function. Methods Eleven cases of benign tumors in the head of pancreas treated surgically were retrospectively analyzed and the advantages of local resection and the factors affecting surgical treatment were examined. Results 1. Local resection is practical and a simple operation mode was used to treat the benign tumors in the head of pancreas. This operation mode could reduce the impact to body, reduce the postoperative complication, facilitate the postoperative recovery, and reserve the digestion function as compared with the conventional Whipple operation; 2.Cholangiotomy is required to prevent from damaging bile duct if the tumors were close to the bile duct; 3. Adopting side to side anastomosis of pancreatic wound surface with jejunum could decrease the occurrence of pancreas fistula. Conclusion Local resection is the priority operation mode to treat benign tumors in the head of pancreas for reserving pancreatic function.