慢性胰腺炎病变类型与手术方式的选择

A study on the pathological type and surgical therapy of chronic pancreatitis

目的探讨慢性胰腺炎手术治疗方案的选择。方法回顾性分析华西医院2009年3月至2013年11月收治的慢性胰腺炎手术患者229例，总结其临床资料与随访信息，比较手术治疗疗效。结果229例患者依据不同病变类型分别行引流术或切除术两类手术。57例行纵向胰管切开胰肠吻合术，118例行胰头部分切除胰肠吻合术（Frey法105例，Berne法6例，Beget法7例），7例行胰十二指肠切除术，21例行胰体尾切除术，26例行其他手术。术后疼痛缓解率89．3％，总并发症发生率19．6％。结论慢性胰腺炎的不同术式有其特定适应证，应根据其病变类型选择手术方式以保证手术疗效。

Objective To evaluate surgical therapies for chronic pancreatitis. Method The clinical data of 229 patients admitted for chronic pancreatitis during March 2009 to November 2013 in our hospital was retrospectively analyzed, different operation method and their clinical outcome were compared. Results Drainage operations or resection operations were made to all these 229 patients according to different types. 57 patients underwent longitudinal pancreaticojejunostomy （ LPJ procedure）. 118 patients received local resection of the head of pancreas combined with longitudinal pancreaticojejunostomy （ Frey procedure in 105 cases, Berne procedure in 6 cases, Beget procedure in 7 cases）. 7 patients received pancreaticoduodenectomy, 21 patients received distal pancreas resection, 26 patients received other procedures. Post-operative pain relief rate was 89. 3%, overall morbidity was 19. 6%. Conclusions In cases of chronic pancreatitis, different surgical types are adopted according to their individual indications. Operation in accordance with pathological types guarantees clinical outcome.