改良保留十二指肠胰头切除术治疗慢性胰腺炎的疗效分析  

Modified duodenum-preserving pancreatic head resection in treatment of patients with chronic pancreatitis

作　　者：魏洪吉[1] 吴河水[1] 熊炯炘[1] 陶京[1] 周峰[1] 王春友[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院胰腺外科,武汉430022

出　　处：《外科理论与实践》2011年第5期448-451,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:观察改良保留十二指肠的胰头切除术(改良Beger手术)对伴胰头炎性肿块的慢性胰腺炎病人的治疗效果。方法:回顾性分析自2004年1月至2010年12月,在我院胰腺外科接受改良Beger手术治疗的51例伴胰头炎性肿块的慢性胰腺炎病人的临床资料,并对病人术后疼痛症状、生活质量及内分泌功能等进行随访。结果:无手术死亡病例,术后并发症发生率为15.7%,其中胰漏3例,胆漏2例,十二指肠漏1例,腹腔出血1例,切口裂开1例。术后6个月,病人疼痛得到明显缓解,EORTC QLQ-C30疼痛评分由(64.3±5.8)降至(12.5±3.7)(P<0.01),生活质量获显著提高,GLQI生活质量评分由(70.1±5.8)增至(86.4±6.6)(P<0.01);病人内分泌功能未受影响,无新增糖尿病病例。结论:采用改良Beger手术治疗伴胰头炎性肿块的慢性胰腺炎是安全、有效的。Objective To observe the therapeutic efficacy of a modified duodenum-preserving pancreatic head resection procedure in the treatment of patients with chronic pancreatitis and an inflammatory mass in the head of the pancreas.Methods From Jan 2004 to Dec 2010,a modified duodenum-preserving pancreatic head resection procedure was performed in fifty-one patients with chronic pancreatitis and an inflammatory mass in the head of the pancreas.The pain scale in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire（EORTC QLQ-C30）,Gastrointestinal Quality of Life Index（GLQI） questionnaire,and oral glucose tolerance test（OGTT） were used to evaluate the changes in preoperative and postoperative pain symptomatology,quality of life,and endocrine function of the patients correspondingly.Results There was no hospital mortality.The overall postoperative incidence rate of complications was 15.7%,including pancreatic fistula in 3 cases,bile leakage in 2 cases,duodenal fistula in 1 case,intraabdominal bleeding in 1 case and wound disruption in 1 case.Six months after surgery,the mean EORTC QLQ-C30 pain scale decreased from（64.3±5.8） to（12.5±3.7）（P0.01）,the GLQI scale increased from（70.1±5.8） to（86.4±6.6）（P0.01）,the endocrine function was stable and no new diabetes case was found.Conclusions A modified duodenum-preserving pancreatic head resection procedure（modified Beger＇s operation） is safe and effective in the treatment of patients with chronic pancreatitis and an inflammatory mass in the head of the pancreas.

关 键 词：慢性胰腺炎 手术治疗 保留十二指肠胰头切除术 

分 类 号：R657.51[医药卫生—外科学]