保留器官功能的胰腺切除术28例临床分析

Organ preserving pancreatectomy： clinical analysis of 28 cases

目的探讨保留器官功能的胰腺切除术式在治疗胰腺良性及低度恶性肿瘤中的疗效。方法回顾性分析2005年5月至2011年6月施行的28例保留器官功能的胰腺切除术患者的临床资料。结果28例患者行保留十二指肠的胰头切除术7例，中段胰腺切除术9例，行保留脾脏的胰体尾切除术5例，行胰腺肿块局部切除术7例。行保留十二指肠胰头切除术的7例患者术后并发胰瘘1例。行中段胰腺切除术的9例患者术后并发胰瘘1例。行胰腺肿块的局部切除术7例患者中切口脂肪液化2例，均经保守治疗而愈。患者均获得随访，随访时间半年到6年，均无肿瘤复发，无新发糖尿病，脂肪泻及胰腺假性囊肿形成。结论保留器官功能的胰腺切除术治疗胰腺良性或者低度恶性的肿瘤临床疗效确切，且可明显降低手术创伤。

Objective To discuss the proper surgical management for pancreatic benign and low- grade malignancies. Methods The clinical data of 28 cases who accepted organ preserving pancreatectomy from May 2005 to June 2011 was analyzed retrospectively. Results Seven cases underwent duodenum- preserving resection of the head of the pancreas, 9 cases underwent middle segmental pancreatectomy, 5 cases underwent spleen-preserving distal pancreatectomy, 7 cases underwent partial pancreatectomy. Pancreatic fistula occurred in one of 7 cases who accepted duodenum-preserving resection of the head of the pancreas, pancreatic fistula developed in one of 9 cases who accepted middle segmental pancreatectomy. Fat liquefaction occurred in 2 of 7 cases after partial pancreatectomy. These complications were cured by conservative treatment. All cases were followed-up from 6 months to six years. There was no tumor recurrence nor new-onset diabetes mellitus, steatorrhea and pancreatic pseudocyst formation. Conclusions Organ preserving pancreatectomy is effective treatment for pancreatic benign and low-grade malignant tumors.