恶性阻黄行须防性胃空肠短路术的价值

The role of prophylactic gastrojeunostomy for unresectable pancreas and periampullary carcinoma

本文回顾性分析了８７例不能切除壶腹周围，胰头癌梗阻性黄疸病例的治疗结果，一组行单纯黄疸内引流术；另一组在黄疸内引流同时行预防性胃空肠吻合术。２组病倒手术死亡率，住院时间长短基本相同，术手并发症，黄疸内引流同时预防性胃空肠吻合术组略高于单纯黄疸内引流组，但无统计学意义。而单纯黄疸内引流组术后存活３月以上４２例中，２０例（４８％）由于肿瘤发展出现上消化道梗阻。提出对胰头癌，壶腹周围癌梗阻性黄疸患者，只要肿瘤腹腔内无广泛转移，在黄疸内引流同时，应行预防性胃空肠短路术。

ighty-seven patients undergoing palliative bypass for unresectable pancreas and periampullary carcinoma were reviewed.All patients presenting with biliary obstruction,48 underwent a biliary bypass only and 39,a biliary bypass plws a prophylacticgastrkjejunostomy.operative mortality and the postoperative hospital stay were similar for these two groups; postoperative com-plications tended to be more common in patients undergoing the double bypass.patients undergoing biliary bypass alone requiredsignificantly more subsequent operation;usually for gasterduodenal obstruetion.Thus,it appears that a prophylactic gastroje-junostomy shoud be performed upon most patients with unresectable periampullary carcinoma presenting with biliary obstruc-tion.