胰十二指肠切除术治疗恶性肿瘤

Pancreaticoduodenectomiy for malignancy

目的 探讨降低胰十二指肠切除术后并发症及死亡率的措施。方法 回顾性分析 1988～ 1998年间连续施行的 6 0例胰十二指肠切除术的并发症及死亡率 ,总结其经验与教训。结果 本组 6 0例术后出现并发症的 18例 (30 % ) ,其中胰瘘 8例。住院期死亡 2例(3 3% )。采用单层吻合技术进行胰肠、胆肠重建的 14例无 1例术后并发胰瘘及胆瘘 ,亦无手术死亡。结论 降低胰十二指肠切除术后并发症及死亡率的关键在于外科手术操作的精细及积极的围术期处理。单层吻合技术用于胰十二指肠切除胰肠、胆肠重建是降低术后胰瘘、胆瘘的有效措施。

Objective To investigate the way to decrease the morbidity and moritality of pancreaticoduodenectomy. Methods The morbidity and mortality were analysed in 60 cases of pancreaticoduodenectomies from 1988 to 1998. Results The postoperative morbidity rate was 30%(18/60), including pancreatic fistula in 8 cases. The in hospital mortality rate was 3.3%(2/60). Single layered anastomosis was used to accomplish pancreatoenteric and biliary enteric reconstruction in 14 cases. Of the 14 cases, no postoperative pancreatic or biliary fistula occurred and no in hospital death. Conclusions[WT5”,6BZ] The key points to decrease the morbidity and mortality of pancreaticoduodenectomy are delicate operative maneuver and effective perioperative treatment. Signle layered anastomosis used in pancreatoenteric and biliary enteric reconstruction of pancreaticoduodenectomy is an efficacious method to decrease the postoperative pancreatic and biliary fistula.