摘要
目的:研究胰腺中段切除术(CP)在胰腺外科中的应用及临床意义。方法:采用回顾性描述性研究方法,对青岛大学附属医院肝胆外科2007年2月—2017年12月39例行CP患者的临床资料进行分析。6例胰腺中段肿瘤在达芬奇机器人辅助系统下完成。消化道重建采用胰空肠吻合或胰胃吻合。观察所有患者的治疗情况,包括术前影像学资料,手术情况与围手术期相关指标。采用门诊和电话方式进行随访,内容包括空腹血糖水平、消瘦、厌食、腹泻等症状以及预后。结果:(1)39例患者成功行CP,术后发生胰瘘20例(51.28%)。其中生化瘘19例(48.72%),均经非手术治疗治愈;B级瘘1例(2.56%),经CT引导下穿刺引流后治愈;无C级瘘出现。39例患者术后并发症均经对症支持治疗后好转,无死亡病例。(2)39例患者均获得术后随访,平均随访时间31个月(4～72个月)。术后血糖水平(4.26～11.79mmol/L,7.10±1.81 mmol/L)与术前(3.37～13.36 mmol/L,6.49±2.50 mmol/L)比较,差异无统计学意义(t=1.231,P>0.05)。术后无新发糖尿病患者。39例患者均未出现厌食、脂肪泻及体质量下降改变等情况。结论:CP是一种治疗胰腺颈体部良性肿瘤和交界性肿瘤的有效方法,可较好地保存术后胰腺的内、外分泌功能,提高患者的生活质量。
Objective:To study the advantages and complications of central pancreatectomy(CP)in treatment of benign and low malignant pancreatic tumor.Methods:Clinical data about 39 patients who underwent CP in our department from February 2007 to December 2017 were retrospectively analyzed.39 patients underwent central pancreatectomy,that they gastrointestinal reconstruction were use the pancreaticojejunostomy or pancreaticogastrostomy.Results:39 patients who underwent central pancreatectomy.According to the International Pancreatic Fistula Definition Study Group(ISGPF)standards,biochemical leak occurred in 19 patients(48.72%)after operation and cured after conservative treatment,class B pancreatic fistula occurred in 1 Patients(2.56%),who was cured by puncture drainage guided by CT and anti-infective treatment.The postoperative complications in 39 patients were improved after symptomatic treatment,and no deaths occurred in postoperative patients.The patients were followed up for 4-72 months.All patients have a good quality of life,without new onset diabetes and tumor recurrence.The preoperative blood glucose level was 3.37-13.36 mmol/L(6.49±2.50)mmol/L,postoperative blood glucose level was 4.26-11.79 mmol/L(7.10±1.81)mmol/L.There was no significant difference between the two groups(t=1.231,P>0.05).The CP patients exocrine function was not impaired,and there was no steatorrhea and anorexia appearance after surgery in CP patients.Conclusion:Central pancreatectomy is a safe and reliable procedure for benign and low malignant tumors in pancreatic neck and body,which can preserve the endocrine and exocrine function of patients.In summary,this surgical procedure allows patients to improve their postoperative quality of life.
作者
谈震
周斌
陈鹏
王涛
郭卫东
TAN Zhen;ZHOU Bin;CHEN Peng;WANG Tao;GUO Wei-dong(Department of Hepatopancreatobiliary Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266021,China)
出处
《中国现代普通外科进展》
CAS
2018年第12期939-942,946,共5页
Chinese Journal of Current Advances in General Surgery
基金
国家自然科学基金青年项目资助(81302077)
关键词
胰腺肿瘤
良性
胰腺中段切除术
内分泌功能
外分泌功能
Pancreatic tumor,benign
Central pancreatectomy
Endocrine function
Exocrine function
