保留十二指肠胰头切除术九例临床分析

Duodenum-preserving pancreatic head resection：a clinical analysis of 9 cases

目的总结保留十二指肠的胰头切除术（DPPHR）在治疗慢性胰腺炎及胰腺良性和低度恶性肿瘤中的疗效和经验。方法回顾性分析我院2006年9月至2011年9月施行该术式9例患者临床资料，总结手术适应证、手术策略及技巧。结果无手术死亡。术后发生胰瘘1例，经保守治疗后痊愈。无胆瘘、十二指肠瘘、腹腔感染及胰腺假性囊肿。术后7例患者获得随访，慢性胰腺炎患者术后症状缓解明显，所有肿瘤患者无复发，无术后糖尿病、胆总管狭窄、胰岛素瘤患者血糖恢复至正常。结论DPPHR是治疗慢性胰腺炎及胰头部良性病变的安全有效的术式。

Objective To summarize the therapeutic effect and experiences in curing chronic pancreatitis and pancreatic benign and low-grade malignant tumors with duodenum-preserving pancreatic head resection（DPPHR）. Methods The clinical data of 9 patients with DPPHR who were admitted be- tween September 2006 and September 2011 in our hospital were retrospectively analyzed to summarize the operation indications and operation strategies and skills. Results No operation death was found. Pancreat- ic leakage occurred in one patient and was cured by conservative treatment. There was no biliary fistula, duodenal fistula, abdominal infection or pancreatic pseudocysts, and the total incidence of post-operative complications was 11.1%. Seven patients acquired follow-up, showing that the condition of patients with chronic pancreatitis was improved evidently. There were no recurrence, postoperative diabetes or common bile duct stenosis in any patients. The blood glucose of the insulinoma patient returned to normal. Conclusion DPPHR is a safe and effective operative method for the treatment of chronic pancreatitis and pancreatic head benign lesion.