外科手术治疗胰管结石23例临床回顾

Retrospective Analysis of 23Patients with Pancreatic Duct Stone by Surgical Operation Treatment

目的探讨外科手术治疗胰管结石的疗效及手术方式的合理选择。方法回顾性分析2003年1月～2010年1月间在我院收治的23例胰管结石病人的临床资料。结果 16例患者行胰管切开取石加胰管空肠Roux-en-Y吻合术(Partington手术),5例行胰十二指肠切除术,2例行胰体尾切除加脾切除术。无严重手术并发症及手术死亡病例发生。术后腹痛、腰背部疼痛及腹泻、黄疸等症状明显缓解,高血糖症状得到不同程度缓解。术中发现胰头癌2例,1例术后19月肿瘤复发转移死亡,1例至今已生存41月,所有生存病人无胰腺癌发生者。结论根据胰管结石部位及胰腺病变的具体情况选择合理的手术方式,能够明显改善患者的生活质量和控制疾病发展。

Objective To approach the curative effect of the pancreatic duct stone by surgical operation and the operative technique＇ s rational choice. Method Retrospective analysis of 23 cases pancreatic duct stone patients＇ clinical data during Jan 2003 to Jan 2010 in our hospital. Results 16 cases by calculus removed after section of pancreatic duct and Roux-en- Y type pancreaticojejunostomy,5 cases by pancreatieoduodenectomy,2 cases by partial pancreatectomy combined with splenectomy. No severe complications of surgery and operative deaths occured. The symptoms of abdominal pain,lumbodorsal pain, diarrhea and jaundice release apparently, and hyperglycemia have shown some improvement. We found 2 cases of carcinoma of head of pancreas, between which,one died of recurrence tumor with in 19 months, another remained alive until now. All the 23 cases have no pancreatic cancer occure. Conclusion By selecting the rational surgical operation on the basis of site of the calculus and specific conditions of the pancreas ,we can improve their quality of life apparently and control the development of the disease.