胰头导管内乳头状黏液性瘤:切除或剜除术  

Side-branch intraductal papillary mucinous neoplasms of the pancreatic uncinate: resection or enucleation

作　　者：温自强[1,2] 刘嘉哲[2] 黄新余[2] 

机构地区：[1]苏州大学医学院普外科,江苏苏州215000 [2]上海交通大学附属第六人民医院普外科,上海200233

出　　处：《外科理论与实践》2014年第1期40-43,共4页Journal of Surgery Concepts & Practice

摘　　要：目的:回顾分析胰头或钩突分支胰管型导管内乳头状黏液性瘤(IPMN)行局部剜除术(EN)的病人与行胰十二指肠切除术(PD)的病人进行比较,观察行两者的围手术期效果。方法:对上海第六人民医院1995年6月至2010年6月共132例胰头或钩突IPMN病人进行回顾性分析,局部剜除术(EN)组32例,胰十二指肠切除术(PD)组100例,通过X线检查发现其中19例适合行EN。结果:EN组与PD组相比,手术时间缩短(P<0.05),出血量减少(P<0.05)。然而两组病人总胰漏发生率与C级胰漏率无统计学差异。结论:对于胰头或钩突分支胰管型IPMN病人行EN与PD相比,EN出血少、手术时间短,而并发症发生率、死亡率及术后住院天数两者无统计学差异。因此,对于单病灶分支胰管型IPMN,EN是一种更合适和有效的手术方式。Objective To compare the peri-operative outcomes in patients with side-branch intraductal papillary mucinous neoplasms （IPMN） of the pancreatic head/uncinate undergoing enucleation （EN） and pancreaticoduodenectomy （PD）. Methods Retrospective review of 132 patients with pancreatic head/uncinate IPMN in the Sixth People＇s Hospital from 1995 June to 2010 June. Enucleation was performed in 32 patients （EN） and PD was performed in 100 patients （PD） with 19 of these radiographically amenable to EN. Results Operative time was shorter and blood loss was less in the EN group compared with PD group（P〈0.05）. However overall pancreatic fistulae rate and the rate of grade C pancreatic fistulae was no statistically signifciant differences. Conclusions Compared with PD, EN for IPMN has the advantage of less blood loss, shorter operative time and similar morbidity, mortality, hospital length of stay （LOS）. EN should be considered as a more appropriate and effective surgery for patients with unifocal side-branch IPMN.

关 键 词：导管内乳头状黏液性肿瘤 局部剜除术 胰十二指肠切除术 

分 类 号：R735.9[医药卫生—肿瘤]