保留幽门胰十二指肠切除术与标准Whipple术围手术期观察:连续112例分析

Postoperative recovery after pylorus-preserving pancreaticoduodenectomy versus conventional Whipple operation: an analysis of 112 consecutive cases

目的 分析保留幽门胰十二指肠切除术 (PPPD)与Whipple手术在围手术期恢复情况。方法 将 49例PPPD与同期 63例Whipple术后恢复情况作对照比较。 结果 PPPD组手术时间、术后住院天数减少 ,手术并发症略低 ,术后营养状况相似 ,但均无统计学差异。PPPD组病人放置胃管时间、胃排空延迟发生率大于Whipple组 ,但无统计学差异。既往有、无腹部手术史者胃排空延迟发生率分别为 3 5 5%、11 1% ,术后有、无手术并发症者胃排空延迟发生率分别为 46 2 %、9 3 % ,两组比较差别均有统计学意义 (P <0 0 5)。结论 PPPD是一种安全的手术 。

Objective To analyze the postoperative recovery after pylorus preserving pancreaticoduodenectomy (PPPD) versus conventional Whipple operation. Methods The postoperative recovery was compared between 49 patients receiving PPPD and 63 undergoing Whipple operation from 1998 to 2001. Results Operative duration, postoperative hospital stay, incidence of complications were lower but gastric suction time and delayed gastric emptying occurrence were higher in patients receiving PPPD than in those undergoing Whipple operation. The patients with the history of abdominal operation and those with intraabdominal complications showed a higher incidence of delayed gastric emptying (35 5%:11 1%, 46 2%:9 3%, P<0 05). Conclusions PPPD is a safe surgical procedure and the pylorus preservation does not influence the incidence of delayed gastric emptying and the postoperative recovery.