胰管梗阻的诊断和治疗  

Diagnosis and Treatment of Pancreatic Duct Obstruction.

作　　者：施维锦[1] 张晞文[1] 

机构地区：[1]上海第二医科大学附属仁济医院普外科,200001

出　　处：《外科理论与实践》2001年第2期79-81,共3页Journal of Surgery Concepts & Practice

摘　　要：提出胰管梗阻所致胰高压在胆胰疾病中造成病人剧烈腹痛和消化道功能紊乱的作用以及手术缓解胰高压的重要性。方法：２７例诊断为胰管梗阻的患者中，１１例为慢性胰腺炎，１６例为晚期胰腺癌或壶腹周围癌。其中慢性胰腺炎有６例为胰管多发性狭窄伴扩张，手术将胰管纵行劈开并与空肠行大口侧侧吻合，另５例仅出口狭窄者行胰管空肠侧端吻合；１６例晚期肿瘤患者，仅５例行胰管空肠内引流术。结果：１１例慢性胰腺炎内引流手术后经长期随访除一例偶有上腹轻度疼痛外，其余１０例症状均明显好转。其余消化道症状亦皆明显好转。１６例晚期肿瘤所致的胰管梗阻病人，５例行胰管空肠吻合术，术后病人疼痛均明显好转。结论：胰管阻塞可引起胰高压，后者可能是造成慢性疼痛和消化不良的重要原因，在胆胰手术过程中应充分地认识其重要性，以选择适当的术式。To explore the diagnosis and surgical treatment of pancreatic duct obstruction. Methods: Twenty-seven cases of cholangiopancreatical diseases with pancreatic duct obstruction were admitted in our hospital. Among them, eleven cases were chronic pancreatitis, 16 were late stage of pancreatic or peri-ampullary cancer. In the former group, Partington operation was performed to 6 cases; side-to- end pancreato-jejunostomy was carried out to the other 5 cases with stricture in the outlet of the pan- creatic duct. For those with malignant diseases, only 5 patients underwent pancreato-jejunostomy. Re- sults: After operation, the symptoms(including abdominal pain and indigestion) were released dramati- cally in 10 of 15 patients with pancreatitis, compared to those of 5 of 16 patients with malignant di- seases. Conclusions: Abdominal pain and indigestion were the common symptoms in cholangio-pan- creatical disorders, pancreatic duct hypertension caused by pancreatic duct obstruction is the likely ex- planation for it. Appropriate operative procedures should be performed to drain the pancreatic duct.

关 键 词：胰高压 胰管扩张 慢性胰腺炎 壶腹周围癌 胰肠吻合术 胰管梗阻 诊断 

分 类 号：R657.5[医药卫生—外科学]