保留十二指肠的胰头切除术治疗胰头部良性肿瘤

Duodenum-preserving pancreatic head resection （DPPHR） in treating patients with benign lesions in the head of the pancreas

目的探讨保留十二指肠的胰头切除治疗胰头部良性肿瘤的术式及疗效。方法2003年2月至2011年8月河南省人民医院肝胆胰腺外科对收治的胰头部良性肿瘤21例患者实施了保留十二指肠的胰头切除术，其中男13例，女8例，年龄30-48岁，肿块直径2．0-5．6cm。所有患者均保留了胰十二指肠上后动脉，离断了一支或多支其他供血动脉。结果本组患者无手术死亡病例，7例患者术后出现胰漏，发生率为33．3％（7／21）。术前腹痛患者术后明显缓解，2例反复低血糖症状的患者血糖恢复正常。顽固性腹泻患者症状获得完全缓解，大便恢复正常。随访期内无复发病例。结论保留十二指肠的胰头切除术治疗胰头部良性肿瘤是可行的。保留胰十二指肠上后动脉的完整性对保证十二指肠及胰头段胆管的血供非常重要。

Objective To evaluate the procedure and the therapeutic efficacy of duodenum- preserving pancreatic head resection （DPPHR） in treating benign lesions in the head of the pancreas. Methods From February 2003 to August 2011, DPPHR was performed in 21 patients with benign lesions in the head of the pancreas. Thirteen patients were male and eight were female. Age ranged from 30 to 48 years, and the lesions ranged from 2. 0 cm to 5.6 cm in diameter. Posterior superior panereaticoduodenal artery was conserved in all patients. Results There was no hospital death. Pancreatic fistula was the main and the most often morbidity, occurring in 33.3%. After operation all patients with preoperative abdominal pain were completely pain free. Preoperative hypoglycemia in 2 patients turned to eugycemia. There was no recurrences report during following up. Conclusions DPPHR was safe and effective in treating benign lesion in the head of pancreas. It was important in preserving blood supply to the duodenum by posterior superior panereaticoduodenal artery.