胰腺中段切除术治疗胰腺良性肿瘤的适应证与并发症(附26例)

Indications and complications of medial pancreatectomy: A report of 26 cases

  • 摘要: 目的 讨论胰腺中段切除术治疗胰腺中段良性肿瘤的优点和术后并发症。 方法 回顾性分析2008年1月- 2012年9月本科实行的胰腺中段切除术病例26例。 结果 26例病人行胰腺中段切除、胰肠Roux-en-Y吻合。手术时间(150.6±40.3) min,术中出血(180.7±68.5) ml,保留远端胰腺长度平均为(6.5±1.7) cm。术后病理诊断均为良性病变。术后住院时间(24.4±15.3) d。术后出现胰瘘12例(46.1%),均为A级,行保守治疗后均痊愈。1例术后发生腹腔内大出血导致死亡。术后随访3 ~ 18个月,肿瘤无复发情况,1例外分泌功能受损,1例新发糖尿病,无糖尿病病情加重病例。 结论 胰腺中段切除术是治疗胰腺颈部及体部良性和低度恶性肿瘤较为安全的手术方式,可以更多地保存病人的胰腺内、外分泌功能,提高了病人术后的生活质量。

     

    Abstract: Objective To study the advantages and complications of medial pancreatectomy (MP) in treatment of benign pancreatic tumor. Methods Clinical data about 26 patients who underwent MP in our department from January 2008 to September 2012 were retrospectively analyzed. Results The 26 patients underwent MP and Roux-en-Y type pancreatico-jejunostomy respectively, with an operation time of 150.6 ±40.3 min, a blood loss of 180.7 ±68.5 ml, and a mean distal pancreas preservation length of 6.5±1.7 cm. The tumor was diagnosed as a benign lesion after operation. The postoperative hospital stay time of the patients was 24.4±15.3 d. Class A pancreatic fstula occurred in 12 patients (46.1%) after operation and cured after conservative treatment. One patient died of intra-abdominal massive hemorrhage. The patients were followed up for 3-18 months, during which no tumor reoccurred. The exocrine function was impaired in 1 patient, and diabetes mellitus was found in 1 patient, which did not exacerbate. Conclusion MP is a safe procedure for benign and low malignant tumors in pancreatic neck and body, and can preserve the endocrine and exocrine function of patients, thus improving their postoperative quality of life.

     

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