全胰切除术治疗胰腺良恶性疾病11例

Total pancreatectomy for treatment of 11 cases with benign or malignant pancreatic diseases

目的探讨全胰切除术(total pancreatectomy,TP)治疗胰腺良恶性疾病的指征、安全性、可行性,总结临床经验。方法回顾性分析2018年1月至2020年12月在中国科学技术大学附属第一医院胆胰外科行全胰切除术的11例胰腺良恶性疾病患者的临床资料。结果 11例中慢性胰腺炎3例,胰腺导管腺癌4例,胰腺黏液癌2例,胰腺导管内乳头状黏液肿瘤(intraductal papillary mucinous neoplasms,IPMN)1例,神经内分泌肿瘤1例。11例均成功施行全胰切除术,其中腹腔镜下全胰切除术2例。术后并发胃十二指肠动脉残端出血1例。8例获得随访,平均随访20个月,术后每日胰岛素总量(31.22±4.79)U,血糖控制基本稳定。结论全胰切除术在治疗胰腺良恶性疾病中是安全、可行的,但应严格掌握适应证,对于胰腺癌患者,可以提高R0切除率。

objective To explore the indications,safety,and feasibility of total pancreatectomy (TP) in treatment of benign and malignant pancreatic diseases,and to summarize clinical experience.Methods Clinical data of 11 patients with benign or imalignant panceratic diseases receiving TP in Department of Pancreatic Surgery,the First Affiliated Hospital of University of Science and Technology of China from Jan.2018 to Dec.2020 were retrospectively analyzed.Results Among the 11 cases,3 cases were chronic pancreatitis,4 cases were pancreatic ductal adenocarcinoma,2 cases were pancreatic mucinous carcinoma,1 case was intraductal papillary mucinous neoplasms (IPMN),and 1 case was neuroendocrine tumor.TP was successfully performed in the 11cases,including 2 cases under laparoscopic pancreatectomy.One case had postoperative gastroduodenal artery stump bleeding.Eight cases were followed up with an average time 20 months.The total daily insulin amount was (31.22±4.79)U after the operation,and the blood glucose control was basically stable.Conclusion TP is safe and feasible in treatment of benign and malignant pancreatic diseases,but the indications should be strictly controlled.For patients with pancreatic cancer,R0 resection rate can be improved.