胰管结石19例的外科治疗  

Surgical Management of Pancreatolithiasis

作　　者：詹勇强[1] 王成友[1] 倪勇[1] 张敏杰[1] 黄文坚[1] 韩庆[1] 庄礼钊[1] 

机构地区：[1]深圳市第二人民医院肝胆外科,广东深圳518035

出　　处：《医学临床研究》2009年第8期1448-1449,1452,共3页Journal of Clinical Research

摘　　要：【目的】探讨胰管结石外科治疗方法。【方法】回顾性分析本院1984-2006年收治的19例胰管结石患者的临床资料。根据其病因和合并症的情况、胰管结石的分布以及胰管狭窄部位和程度采取不同的手术方式。【结果】19例中胰腺癌者8例，慢性胰腺炎者8例，不明原因者3例。临床表现为腹痛或上腹不适者15例，糖尿病者15例，消瘦者10例，脂肪泻者8例。全组患者胰管结石均经手术治愈。术后无残余结石，15例腹痛或腹部不适者均获不同程度的缓解，10消瘦者体重有所增加；4／15例糖尿病及5／8脂肪泻有所缓解。术后4例患者出现胰漏。并发胰腺癌者术后存活时间6～22个月。【结论】胰管结石一经确诊后应争取早日手术治疗，根据合并疾病的不同、胰管结石分布以及胰管狭窄情况具体选择。原则上应解除胰管狭窄，取尽胰管结石，建立通畅引流。[Objective] To study the proper management of pancreatolithiasis. [Methods] The clinical data of 19 cases of pancreatolithiasis were reviewed retrospectively. Operations were carefully designed and carried according to the etiology, complications, stone location and stricture site of pancreatic duct. [Results] The etiology of pancreatic stone was chronic pancreatitis in 8 cases, pancreatic carcinoma in 8 cases and unknown in 3 cases. Clinical manifestations showed abdominal pain or discomfort in 15 cases, diabetes mellitus in 15 cases, symptosis in 10 cases and steatorrhea in 8 cases. All the patients were cured without residue stones. Fifty cases of abdominal pain or discomfort obtained the relief, 10 cases of symptosis had weight gain, 4 cases of diabetes mellitus and 5 cases of steatorrhea were relieved. Postoperative pancreatic fluid leakage happened in 4 ca ses. The patients of pancreatic carcinoma gained a survival of 6-22 months. [Conclusion] Pancreatolithiasis should be operated early. The operation should be planed carefully according to the etiology, complicating disease, location of stone and condition of ductal stricture. The pancreatic stones must be removed, ductal stricture must be resolved and pancreatic drainage must be set up.

关 键 词：结石/外科学 胰腺管 

分 类 号：R657.5[医药卫生—外科学]